| NAME |
INV-COVID 19 (MODERNA) BIVALENT BOOSTER,50MCG/0.5ML,INJ,2.5ML |
| VA GENERIC NAME |
COVID-19 VACCINE |
| DOSAGE FORM |
INJ,SUSP |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY NAME |
COVID-19 VACCINE INJ,SUSP |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2022-09-08 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
INV-COVID 19 (MODERNA) BIVAL BOOST 2.5ML |
| VA PRODUCT IDENTIFIER |
I0743 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4041680 |
| EFFECTIVE DATE/TIME |
-
- 2022-09-08 00:00:00
- STATUS: ACTIVE
|