TESAMORELIN 1MG/VIL INJ,KIT (22038)    VA PRODUCT (50.68)

Name Value
NAME TESAMORELIN 1MG/VIL INJ,KIT
VA GENERIC NAME TESAMORELIN
DOSAGE FORM INJ,LYPHL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 1
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2020-10-15 00:00:00
UNITS MG/VIAL
NATIONAL FORMULARY NAME TESAMORELIN INJ,LYPHL
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 TESAMORELIN 1MG/VIL INJ KIT
VA PRODUCT IDENTIFIER T0756
TRANSMIT TO CMOP YES
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4030273
EFFECTIVE DATE/TIME
  • 2010-12-03 00:00:00
    STATUS:   ACTIVE
  • 2020-10-15 00:00:00
    STATUS:   INACTIVE
  • 2020-10-15 00:00:00
    STATUS:   INACTIVE
  • 2020-10-15 00:00:00
    STATUS:   INACTIVE