TESTOSTERONE 1% 2.5GM/PKT GEL,TOP (14379)    VA PRODUCT (50.68)

Name Value
NAME TESTOSTERONE 1% 2.5GM/PKT GEL,TOP
VA GENERIC NAME TESTOSTERONE
DOSAGE FORM GEL,TOP
FDA MED GUIDE Testosterone_Gel_(Generic)_(2021).pdf
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Schedule III Non-Narcotics
STRENGTH 1
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2010-01-14 00:00:00
UNITS %
NATIONAL FORMULARY NAME TESTOSTERONE GEL,TOP
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 TESTOSTERONE 1% 2.5GM/PKT TOP GEL
VA PRODUCT IDENTIFIER T0492
TRANSMIT TO CMOP YES
VA DISPENSE UNIT PKT
MASTER ENTRY FOR VUID YES
VUID 4014743
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2010-01-14 00:00:00
    STATUS:   INACTIVE
  • 2010-01-14 00:00:00
    STATUS:   INACTIVE