LEVOTHYROXINE NA 0.025MG CAP (24099)    VA PRODUCT (50.68)

Name Value
NAME LEVOTHYROXINE NA 0.025MG CAP
VA GENERIC NAME LEVOTHYROXINE
DOSAGE FORM CAP,ORAL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 0.025
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2013-08-23 00:00:00
UNITS MG
NATIONAL FORMULARY NAME LEVOTHYROXINE CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Both Inpatient and Outpatient
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 0.025MG CAP
VA PRODUCT IDENTIFIER L0595
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4032628
EFFECTIVE DATE/TIME
  • 2013-08-20 00:00:00
    STATUS:   ACTIVE