AMPICILLIN NA 250MG/VIL INJ,ADD-VANTAGE (734)    VA PRODUCT (50.68)

Name Value
NAME AMPICILLIN NA 250MG/VIL INJ,ADD-VANTAGE
VA GENERIC NAME AMPICILLIN
DOSAGE FORM INJ
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 250
INACTIVATION DATE 2002-09-26 00:00:00
UNITS MG/VIAL
DSS NUMBER 21
NATIONAL FORMULARY NAME AMPICILLIN INJ
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
VA PRINT NAME AMPICILLIN NA 250MG/VI INJ,ADD-VANTAGE
VA PRODUCT IDENTIFIER A0581
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4001345
EFFECTIVE DATE/TIME
  • 2002-09-26 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE