M.T.E.-5 INJ,CONC (7029) VA PRODUCT (50.68)

Name	Value
NAME	M.T.E.-5 INJ,CONC
VA GENERIC NAME	CHROMIC CHLORIDE/CUPRIC CHLORIDE/MANGANESE SULFATE/SELENIUM/ZINC
DOSAGE FORM	INJ,SOLN
ACTIVE INGREDIENTS	CHROMIC CHLORIDE STRENGTH: 10 UNITS: MCG/ML CHROMIUM (AS CHROMIC CHLORIDE) STRENGTH: 10 UNITS: MCG/ML ZINC SULFATE STRENGTH: 5 UNITS: MG/ML CUPRIC CHLORIDE STRENGTH: 1 UNITS: MG/ML MANGANESE SULFATE STRENGTH: 0.5 UNITS: MG/ML COPPER (AS CUPRIC SULFATE) STRENGTH: 1 UNITS: MG/ML SELENIUM STRENGTH: 60 UNITS: MCG/ML MANGANESE (AS SULFATE) STRENGTH: 0.5 UNITS: MG/ML ZINC (AS SULFATE) STRENGTH: 5 UNITS: MG/ML SELENIUM (AS SELENIOUS ACID) STRENGTH: 60 UNITS: MCG/ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2004-11-18 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	CHROMIC CHLORIDE/CUPRIC CHLORIDE/MANGANESE SULFATE/SELENIUM/ZINC 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	NO
VUID	4007539
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2005-12-08 00:00:00 STATUS: ACTIVE 2008-09-02 00:00:00 STATUS: INACTIVE 2008-09-12 00:00:00 STATUS: ACTIVE 2004-11-18 00:00:00 STATUS: INACTIVE 2009-05-26 00:00:00 STATUS: INACTIVE