TESTOSTERONE 5.5MG/PUMP GEL,NASAL,60D (25574)    VA PRODUCT (50.68)

Name Value
NAME TESTOSTERONE 5.5MG/PUMP GEL,NASAL,60D
VA GENERIC NAME TESTOSTERONE
DOSAGE FORM GEL,NASAL
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Schedule III Non-Narcotics
STRENGTH 5.5
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG/PUMP
NATIONAL FORMULARY NAME TESTOSTERONE GEL,NASAL
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 5.5MG/PUMP NASAL GEL 60D
VA PRODUCT IDENTIFIER T0890
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4034306
EFFECTIVE DATE/TIME
  • 2015-03-19 00:00:00
    STATUS:   ACTIVE