CAFFEINE 125MG/NA BENZOATE 125MG/ML INJ (8982) VA PRODUCT (50.68)

Name	Value
NAME	CAFFEINE 125MG/NA BENZOATE 125MG/ML INJ
VA GENERIC NAME	CAFFEINE/SODIUM BENZOATE
DOSAGE FORM	INJ
ACTIVE INGREDIENTS	CAFFEINE STRENGTH: 125 UNITS: MG/ML SODIUM BENZOATE STRENGTH: 125 UNITS: MG/ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	1
NATIONAL FORMULARY NAME	CAFFEINE/SODIUM BENZOATE 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
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	CAFFEINE 125MG/NA BENZOATE 125MG/ML INJ
VA PRODUCT IDENTIFIER	C0799
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4009425
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE