TENECTEPLASE,RECOMBINANT 50MG/VIL INJ (14474)    VA PRODUCT (50.68)

Name Value
NAME TENECTEPLASE,RECOMBINANT 50MG/VIL INJ
VA GENERIC NAME TENECTEPLASE
DOSAGE FORM INJ
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 50
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME TENECTEPLASE INJ
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
    COPAY END DATE:   2021-02-03 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2021-02-04 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME TENECTEPLASE,RECOMBINANT 50MG/VIL INJ
VA PRODUCT IDENTIFIER T0494
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VIL
MASTER ENTRY FOR VUID YES
VUID 4014838
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE