| NAME |
LEUPROLIDE ACETATE (VIADUR) 72MG (12 MONTH) INJ,IMPLANT |
| VA GENERIC NAME |
LEUPROLIDE |
| DOSAGE FORM |
INJ/IMPLANT |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
72 |
| INACTIVATION DATE |
2010-07-07 00:00:00 |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
LEUPROLIDE INJ/IMPLANT |
| 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 |
VIADUR 72MG (12 MONTH) IMPLANT |
| VA PRODUCT IDENTIFIER |
L0449 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4027959 |
| EFFECTIVE DATE/TIME |
-
- 2008-10-08 00:00:00
- STATUS: ACTIVE
-
- 2010-07-07 00:00:00
- STATUS: INACTIVE
|
