HYALURONIC ACID (JUVEDERM ULTRA) SYR (19081)    VA PRODUCT (50.68)

Name Value
NAME HYALURONIC ACID (JUVEDERM ULTRA) SYR
VA GENERIC NAME HYALURONIC ACID
DOSAGE FORM INJ
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2010-03-10 00:00:00
NATIONAL FORMULARY NAME HYALURONIC ACID INJ
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME HYALURONIC ACID (JUVEDERM ULTRA) SYR
VA PRODUCT IDENTIFIER H0535
TRANSMIT TO CMOP YES
VA DISPENSE UNIT SYR
MASTER ENTRY FOR VUID YES
VUID 4026919
EFFECTIVE DATE/TIME
  • 2007-12-20 00:00:00
    STATUS:   ACTIVE
  • 2010-03-10 00:00:00
    STATUS:   INACTIVE
  • 2010-03-10 00:00:00
    STATUS:   INACTIVE