AMIKACIN SO4 5MG/ML/NACL 0.9% INJ,BAG,100ML (3229)    VA PRODUCT (50.68)

Name Value
NAME AMIKACIN SO4 5MG/ML/NACL 0.9% INJ,BAG,100ML
VA GENERIC NAME AMIKACIN
DOSAGE FORM INJ,SOLN
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 5
INACTIVATION DATE 2008-09-03 00:00:00
UNITS MG/ML
DSS NUMBER 5
NATIONAL FORMULARY NAME AMIKACIN INJ,SOLN
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
VA PRINT NAME AMIKACIN 5MG/ML/NACL 0.9% INJ BAG 100ML
VA PRODUCT IDENTIFIER A0950
TRANSMIT TO CMOP YES
VA DISPENSE UNIT BAG
MASTER ENTRY FOR VUID YES
VUID 4003799
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2008-09-03 00:00:00
    STATUS:   INACTIVE
  • 2008-09-03 00:00:00
    STATUS:   INACTIVE
  • 2008-09-03 00:00:00
    STATUS:   INACTIVE