CEFOTETAN DISODIUM 1GM/VIL INJ,ADD-VANTAGE (4338)    VA PRODUCT (50.68)

Name Value
NAME CEFOTETAN DISODIUM 1GM/VIL INJ,ADD-VANTAGE
VA GENERIC NAME CEFOTETAN
DOSAGE FORM INJ
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 1
INACTIVATION DATE 2007-01-01 00:00:00
UNITS GM/VIAL
DSS NUMBER 4
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 DISOD 1GM/VIL INJ ADD-VANTAGE
VA PRODUCT IDENTIFIER C0692
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4004886
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-01-01 00:00:00
    STATUS:   INACTIVE