CYCLOPHOSPHAMIDE 200MG/MANNITOL 150MG/VIL INJ (3192)    VA PRODUCT (50.68)

Name Value
NAME CYCLOPHOSPHAMIDE 200MG/MANNITOL 150MG/VIL INJ
VA GENERIC NAME CYCLOPHOSPHAMIDE/MANNITOL
DOSAGE FORM INJ,LYPHL
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 200
INACTIVATION DATE 2009-08-12 00:00:00
UNITS MG/VIAL
DSS NUMBER 4
NATIONAL FORMULARY NAME CYCLOPHOSPHAMIDE/MANNITOL INJ,LYPHL
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
TRANSMIT TO CMOP NO
MASTER ENTRY FOR VUID YES
VUID 4003762
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-19 00:00:00
    STATUS:   INACTIVE
  • 2007-10-10 00:00:00
    STATUS:   ACTIVE
  • 2009-08-12 00:00:00
    STATUS:   INACTIVE