CEFOTETAN DISODIUM 1GM/VIL INJ (4335)    VA PRODUCT (50.68)

Name Value
NAME CEFOTETAN DISODIUM 1GM/VIL INJ
VA GENERIC NAME CEFOTETAN
DOSAGE FORM INJ
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 1
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS GM/VIAL
DSS NUMBER 1
NATIONAL FORMULARY NAME CEFOTETAN INJ
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 CEFOTETAN DISODIUM 1GM/VI INJ
VA PRODUCT IDENTIFIER C0179
TRANSMIT TO CMOP YES
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4004883
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-01-01 00:00:00
    STATUS:   INACTIVE
  • 2008-02-05 00:00:00
    STATUS:   ACTIVE