BERACTANT 25MG/ML SUSP,INTRATHECAL (9745)    VA PRODUCT (50.68)

Name Value
NAME BERACTANT 25MG/ML SUSP,INTRATHECAL
VA GENERIC NAME BERACTANT
DOSAGE FORM SUSP,INTRATHECAL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 25
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2013-05-21 00:00:00
UNITS MG/ML
DSS NUMBER 1
NATIONAL FORMULARY NAME BERACTANT SUSP,INTRATHECAL
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME BERACTANT 25MG/ML SUSP,INTRATHECAL
VA PRODUCT IDENTIFIER B0366
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4010154
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE