SODIUM IODIDE,I-123,200MIC CAP (7488)    VA PRODUCT (50.68)

Name Value
NAME SODIUM IODIDE,I-123,200MIC CAP
VA GENERIC NAME SODIUM IODIDE,I-123
DOSAGE FORM CAP,ORAL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 200
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MIC
DSS NUMBER 3
NATIONAL FORMULARY NAME SODIUM IODIDE,I-123 CAP,ORAL
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 SODIUM IODIDE,I-123,200MIC CAP
VA PRODUCT IDENTIFIER S0649
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4007992
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-25 00:00:00
    STATUS:   INACTIVE
  • 2010-05-12 00:00:00
    STATUS:   ACTIVE