CONTE-PAK-4 INJ (6875) VA PRODUCT (50.68)

Name	Value
NAME	CONTE-PAK-4 INJ
VA GENERIC NAME	CHROMIC CHLORIDE/CUPRIC SULFATE/MANGANESE SULFATE/ZINC SULFATE
DOSAGE FORM	INJ,SOLN
ACTIVE INGREDIENTS	CHROMIC CHLORIDE STRENGTH: 10 UNITS: MCG/ML CUPRIC SULFATE STRENGTH: 1 UNITS: MG/ML ZINC SULFATE STRENGTH: 5 UNITS: MG/ML MANGANESE SULFATE STRENGTH: 0.5 UNITS: MG/ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2009-05-26 00:00:00
DSS NUMBER	13
NATIONAL FORMULARY NAME	CHROMIC CHLORIDE/CUPRIC SULFATE/MANGANESE SULFATE/ZINC SULFATE 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	4007388
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-19 00:00:00 STATUS: INACTIVE 2007-10-10 00:00:00 STATUS: ACTIVE 2009-05-26 00:00:00 STATUS: INACTIVE