MEDROXYPROGESTERONE ACETATE 104MG/0.65ML SYR INJ,SUSP (18689)    VA PRODUCT (50.68)

Name Value
NAME MEDROXYPROGESTERONE ACETATE 104MG/0.65ML SYR INJ,SUSP
VA GENERIC NAME MEDROXYPROGESTERONE
DOSAGE FORM INJ,SUSP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 104
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG/0.65ML
NATIONAL FORMULARY NAME MEDROXYPROGESTERONE INJ,SUSP
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
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 MEDROXYPROGESTERONE 104MG/0.65ML SUSP IJ
VA PRODUCT IDENTIFIER M0742
TRANSMIT TO CMOP NO
VA DISPENSE UNIT SYR
MASTER ENTRY FOR VUID YES
VUID 4026489
EFFECTIVE DATE/TIME
  • 2007-08-30 00:00:00
    STATUS:   ACTIVE