ISOSULFAN BLUE 1% INJ (7165) VA PRODUCT (50.68)

Name	Value
NAME	ISOSULFAN BLUE 1% INJ
VA GENERIC NAME	ISOSULFAN BLUE/POTASSIUM PHOSPHATE/SODIUM PHOSPHATE
DOSAGE FORM	INJ,SOLN
DOT SHIPPING CODE
ACTIVE INGREDIENTS	POTASSIUM PHOSPHATE,MONOBASIC STRENGTH: 2.7 UNITS: MG ISOSULFAN BLUE STRENGTH: 1 UNITS: % SODIUM PHOSPHATE,DIBASIC STRENGTH: 6.6 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
STRENGTH	1
SINGLE/MULTI SOURCE PRODUCT	Multisource
UNITS	%
DSS NUMBER	1
NATIONAL FORMULARY NAME	ISOSULFAN BLUE/POTASSIUM PHOSPHATE/SODIUM PHOSPHATE INJ,SOLN
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	ISOSULFAN BLUE 1% INJ
VA PRODUCT IDENTIFIER	I0568
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4007675
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE