| NAME |
LEUPROLIDE ACETATE (PEDIATRIC) 11.25MG/KIT INJ,SUSP,SA |
| VA GENERIC NAME |
LEUPROLIDE |
| DOSAGE FORM |
INJ,SUSP,SA |
| FDA MED GUIDE |
Leuprolide_(Lupron_Depot-Ped)_(2023).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
11.25 |
| INACTIVATION DATE |
2008-12-30 00:00:00 |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
LEUPROLIDE INJ,SUSP,SA |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
LEUPROLIDE (PED) 11.25MG/KIT SA SUSP INJ |
| VA PRODUCT IDENTIFIER |
L0391 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4026074 |
| EFFECTIVE DATE/TIME |
-
- 2007-05-23 00:00:00
- STATUS: ACTIVE
-
- 2008-12-30 00:00:00
- STATUS: INACTIVE
|
