HYDROXYPROGESTERONE CAPROATE 125MG/ML INJ,REPOSITORY (1086) VA PRODUCT (50.68)

Name	Value
NAME	HYDROXYPROGESTERONE CAPROATE 125MG/ML INJ,REPOSITORY
VA GENERIC NAME	HYDROXYPROGESTERONE
DOSAGE FORM	INJ,REPOSITORY
ACTIVE INGREDIENTS	HYDROXYPROGESTERONE CAPROATE STRENGTH: 125 UNITS: MG/ML
CS FEDERAL SCHEDULE	Unscheduled
STRENGTH	125
INACTIVATION DATE	2007-09-20 00:00:00
UNITS	MG/ML
DSS NUMBER	4
NATIONAL FORMULARY NAME	HYDROXYPROGESTERONE INJ,REPOSITORY
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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4001690
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-20 00:00:00 STATUS: INACTIVE