CYANIDE ANTIDOTE PACKAGE INJ (598) VA PRODUCT (50.68)

Name	Value
NAME	CYANIDE ANTIDOTE PACKAGE INJ
VA GENERIC NAME	AMYL NITRITE/SODIUM NITRITE/SODIUM THIOSULFATE
DOSAGE FORM	KIT
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	AMYL NITRITE STRENGTH: 5 UNITS: MIN SODIUM NITRITE STRENGTH: 300 UNITS: MG SODIUM THIOSULFATE STRENGTH: 12.5 UNITS: GM
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2016-06-15 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	AMYL NITRITE/SODIUM NITRITE/SODIUM THIOSULFATE KIT
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	CYANIDE ANTIDOTE PACKAGE INJ
VA PRODUCT IDENTIFIER	C0679
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	KIT
MASTER ENTRY FOR VUID	NO
VUID	4001210
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2005-12-08 00:00:00 STATUS: ACTIVE 1999-06-07 00:00:00 STATUS: INACTIVE