TESTOSTERONE UNDECANOATE 250MG/ML INJ,SOLN,3ML (24578)    VA PRODUCT (50.68)

Name Value
NAME TESTOSTERONE UNDECANOATE 250MG/ML INJ,SOLN,3ML
VA GENERIC NAME TESTOSTERONE
DOSAGE FORM INJ,SOLN
FDA MED GUIDE Testosterone_Inj_(Aveed)_(2020).pdf
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR NO
CS FEDERAL SCHEDULE Schedule III Non-Narcotics
STRENGTH 250
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG/ML
NATIONAL FORMULARY NAME TESTOSTERONE INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
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 TESTOSTERONE UNDECANO 250MG/ML INJ 3ML
VA PRODUCT IDENTIFIER T0849
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4033176
EFFECTIVE DATE/TIME
  • 2014-03-21 00:00:00
    STATUS:   ACTIVE