PEGADEMASE BOVINE 250UNT/ML INJ IM (9747) VA PRODUCT (50.68)

Name	Value
NAME	PEGADEMASE BOVINE 250UNT/ML INJ IM
VA GENERIC NAME	PEGADEMASE BOVINE
DOSAGE FORM	INJ,SOLN
ACTIVE INGREDIENTS	SODIUM PHOSPHATE,MONOBASIC SODIUM PHOSPHATE,DIBASIC PEGADEMASE BOVINE STRENGTH: 250 UNITS: UNIT/ML SODIUM CHLORIDE
CS FEDERAL SCHEDULE	Unscheduled
STRENGTH	250
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2019-10-15 00:00:00
UNITS	UNIT/ML
DSS NUMBER	1
NATIONAL FORMULARY NAME	PEGADEMASE BOVINE INJ,SOLN
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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4010156
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2019-10-15 00:00:00 STATUS: INACTIVE