METHOTREXATE 22.5MG/0.45ML AUTO INJECTOR (25008)    VA PRODUCT (50.68)

Name Value
NAME METHOTREXATE 22.5MG/0.45ML AUTO INJECTOR
VA GENERIC NAME METHOTREXATE
DOSAGE FORM INJ
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 22.5
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG/0.45ML
NATIONAL FORMULARY NAME METHOTREXATE INJ
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 METHOTREXATE 22.5MG/0.45ML AUTO INJECTOR
VA PRODUCT IDENTIFIER M1033
TRANSMIT TO CMOP NO
VA DISPENSE UNIT INJECTOR
MASTER ENTRY FOR VUID YES
VUID 4033661
EFFECTIVE DATE/TIME
  • 2014-09-11 00:00:00
    STATUS:   ACTIVE