ALLERGENIC EXTRACT, ALTERNARIA MOLD 2% INJ (6747)    VA PRODUCT (50.68)

Name Value
NAME ALLERGENIC EXTRACT, ALTERNARIA MOLD 2% INJ
VA GENERIC NAME ALLERGENIC EXTRACT,ALTERNARIA MOLD
DOSAGE FORM INJ,SOLN
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 2
UNITS %
DSS NUMBER 5
NATIONAL FORMULARY NAME ALLERGENIC EXTRACT,ALTERNARIA MOLD INJ,SOLN
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
TRANSMIT TO CMOP NO
MASTER ENTRY FOR VUID YES
VUID 4007263
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE