SARGRAMOSTIM 250MCG/VIL (PF) INJ (8810) VA PRODUCT (50.68)

Name	Value
NAME	SARGRAMOSTIM 250MCG/VIL (PF) INJ
VA GENERIC NAME	SARGRAMOSTIM
DOSAGE FORM	INJ,LYPHL
ACTIVE INGREDIENTS	SUCROSE STRENGTH: 10 UNITS: MG/VIAL SARGRAMOSTIM STRENGTH: 250 UNITS: MCG/VIL MANNITOL STRENGTH: 40 UNITS: MG/VIAL TROMETHAMINE STRENGTH: 1.2 UNITS: MG/VIAL
CS FEDERAL SCHEDULE	Unscheduled
STRENGTH	250
INACTIVATION DATE	2005-07-21 00:00:00
UNITS	MCG/VIL
DSS NUMBER	2
NATIONAL FORMULARY NAME	SARGRAMOSTIM INJ,LYPHL
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
VA PRINT NAME	SARGRAMOSTIM 250MCG/VIL PF INJ
VA PRODUCT IDENTIFIER	S0205
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	VI
MASTER ENTRY FOR VUID	YES
VUID	4009267
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2005-07-21 00:00:00 STATUS: INACTIVE