| NAME |
VIDARABINE 200MG/ML INJ |
| VA GENERIC NAME |
VIDARABINE |
| DOSAGE FORM |
INJ |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY RESTRICTION |
Refer to HIV/AIDS TAG treatment guidelines
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
200 |
| INACTIVATION DATE |
2000-10-27 00:00:00 |
| UNITS |
MG/ML |
| DSS NUMBER |
2 |
| NATIONAL FORMULARY NAME |
VIDARABINE INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| 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 |
4005813 |
| EFFECTIVE DATE/TIME |
-
- 2000-10-27 00:00:00
- STATUS: INACTIVE
-
- 2005-12-08 00:00:00
- STATUS: INACTIVE
|
