BENZYLPENICILLOYL POLYLYSINE INJ (6201)    VA PRODUCT (50.68)

Name Value
NAME BENZYLPENICILLOYL POLYLYSINE INJ
VA GENERIC NAME BENZYLPENICILLOYL POLYLYSINE
DOSAGE FORM INJ
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
DSS NUMBER 1
NATIONAL FORMULARY NAME BENZYLPENICILLOYL POLYLYSINE INJ
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME BENZYLPENICILLOYL POLYLYSINE INJ
VA PRODUCT IDENTIFIER B0365
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4006722
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-28 00:00:00
    STATUS:   INACTIVE
  • 2010-08-13 00:00:00
    STATUS:   ACTIVE