TESAMORELIN 2MG/VIL INJ,KIT (23974)    VA PRODUCT (50.68)

Name Value
NAME TESAMORELIN 2MG/VIL INJ,KIT
VA GENERIC NAME TESAMORELIN
DOSAGE FORM INJ,LYPHL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 2
SINGLE/MULTI SOURCE PRODUCT Single source
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 2MG/VIL INJ KIT
VA PRODUCT IDENTIFIER T0823
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4032490
EFFECTIVE DATE/TIME
  • 2013-06-20 00:00:00
    STATUS:   ACTIVE
  • 2018-08-15 00:00:00
    STATUS:   INACTIVE
  • 2020-01-09 00:00:00
    STATUS:   ACTIVE