LEVOTHYROXINE NA 0.112MG CAP (23096)    VA PRODUCT (50.68)

Name Value
NAME LEVOTHYROXINE NA 0.112MG CAP
VA GENERIC NAME LEVOTHYROXINE
DOSAGE FORM CAP,ORAL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 0.112
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2019-12-10 00:00:00
UNITS MG
NATIONAL FORMULARY NAME LEVOTHYROXINE CAP,ORAL
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 LEVOTHYROXINE NA 0.112MG CAP
VA PRODUCT IDENTIFIER L0544
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4031488
EFFECTIVE DATE/TIME
  • 2012-06-11 00:00:00
    STATUS:   ACTIVE
  • 2019-12-10 00:00:00
    STATUS:   INACTIVE