ALLERGENIC EXTRACT MIXED GRASSES INJ (7528) VA PRODUCT (50.68)

Name	Value
NAME	ALLERGENIC EXTRACT MIXED GRASSES INJ
VA GENERIC NAME	ALLERGENIC EXTRACT MIXED GRASSES (5A)
DOSAGE FORM	INJ,SOLN
ACTIVE INGREDIENTS	ALLERGENIC EXTRACT, TIMOTHY GRASS STRENGTH: 1 UNITS: UNIT ALLERGENIC EXTRACT, JUNE POLLEN STRENGTH: 1 UNITS: UNIT ALLERGENIC EXTRACT, ORCHARD POLLEN STRENGTH: 1 UNITS: UNIT ALLERGENIC EXTRACT, REDTOP GRASS STRENGTH: 1 UNITS: UNIT ALLERGENIC EXTRACT, SWEET VERNAL STRENGTH: 1 UNITS: UNIT
CS FEDERAL SCHEDULE	Unscheduled
DSS NUMBER	1
NATIONAL FORMULARY NAME	ALLERGENIC EXTRACT MIXED GRASSES (5A) 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	4008032
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE