IDARUBICIN HCL 20MG/VIL INJ (8855)    VA PRODUCT (50.68)

Name Value
NAME IDARUBICIN HCL 20MG/VIL INJ
VA GENERIC NAME IDARUBICIN
DOSAGE FORM INJ,LYPHL
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT
Restrict to Hematology/Oncology
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 20
INACTIVATION DATE 2007-09-20 00:00:00
UNITS MG/VIAL
DSS NUMBER 3
NATIONAL FORMULARY NAME IDARUBICIN 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 IDARUBICIN HCL 20MG/VIL INJ
VA PRODUCT IDENTIFIER I0190
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4009312
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-20 00:00:00
    STATUS:   INACTIVE