| NAME |
ALPROSTADIL 20MCG/VIL IMPULSE INJ,SYSTEM |
| VA GENERIC NAME |
ALPROSTADIL |
| DOSAGE FORM |
INJ |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
20 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
MCG/VIL |
| NATIONAL FORMULARY NAME |
ALPROSTADIL INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ALPROSTADIL 20MCG/VIL IMPULSE INJ SYSTEM |
| VA PRODUCT IDENTIFIER |
A1761 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4033565 |
| EFFECTIVE DATE/TIME |
-
- 2014-08-13 00:00:00
- STATUS: ACTIVE
|
