LEUCOVORIN CALCIUM 50MG/VIL INJ (5972)    VA PRODUCT (50.68)

Name Value
NAME LEUCOVORIN CALCIUM 50MG/VIL INJ
VA GENERIC NAME LEUCOVORIN CALCIUM
DOSAGE FORM INJ
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 50
INACTIVATION DATE 2004-11-18 00:00:00
UNITS MG/VIAL
DSS NUMBER 1
NATIONAL FORMULARY NAME LEUCOVORIN 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 LEUCOVORIN CALCIUM 50MG/VIL INJ
VA PRODUCT IDENTIFIER L0168
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID NO
VUID 4006494
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2005-12-08 00:00:00
    STATUS:   ACTIVE
  • 2008-09-03 00:00:00
    STATUS:   INACTIVE
  • 2004-11-18 00:00:00
    STATUS:   INACTIVE