ESTRADIOL VALERATE 8MG/TESTOSTERONE ENANTHATE 180MG/ML INJ (1091)    VA PRODUCT (50.68)

Name Value
NAME ESTRADIOL VALERATE 8MG/TESTOSTERONE ENANTHATE 180MG/ML INJ
VA GENERIC NAME ESTRADIOL/TESTOSTERONE
DOSAGE FORM INJ (IN OIL)
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2007-09-18 00:00:00
DSS NUMBER 5
NATIONAL FORMULARY NAME ESTRADIOL/TESTOSTERONE INJ (IN OIL)
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 4001695
EFFECTIVE DATE/TIME
  • 2004-11-18 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-18 00:00:00
    STATUS:   INACTIVE