ALPROSTADIL 20MCG/VIL IMPLUSE INJ,SYSTEM (16509)    VA PRODUCT (50.68)

Name Value
NAME ALPROSTADIL 20MCG/VIL IMPLUSE INJ,SYSTEM
VA GENERIC NAME ALPROSTADIL
DOSAGE FORM INJ
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 20
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2014-09-15 00:00:00
UNITS MCG/VIL
NATIONAL FORMULARY NAME ALPROSTADIL INJ
CREATE DEFAULT POSSIBLE DOSAGE YES
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
VA PRINT NAME ALPROSTADIL 20MCG/VIL IMPLUSE INJ SYSTEM
VA PRODUCT IDENTIFIER A1200
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4016872
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE