LEUCOVORIN CALCIUM 10MG TAB (5969)    VA PRODUCT (50.68)

Name Value
NAME LEUCOVORIN CALCIUM 10MG TAB
VA GENERIC NAME LEUCOVORIN CALCIUM
DOSAGE FORM TAB
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 10
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
DSS NUMBER 8
NATIONAL FORMULARY NAME LEUCOVORIN CALCIUM TAB
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 LEUCOVORIN CALCIUM 10MG TAB
VA PRODUCT IDENTIFIER L0084
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4006492
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE