INSULIN,GLARGINE 100UNIT/LIXISENATIDE 33MCG/ML INJ,SOLN,PEN (27382) VA PRODUCT (50.68)

Name	Value
NAME	INSULIN,GLARGINE 100UNIT/LIXISENATIDE 33MCG/ML INJ,SOLN,PEN
VA GENERIC NAME	INSULIN GLARGINE/LIXISENATIDE
DOSAGE FORM	INJ,SOLN
FDA MED GUIDE	Insulin_Glargine-Lixisenatide_(Soliqua)_(2022).pdf
FORMULARY DESIGNATOR TEXT	VISNs may choose a preferred agent (glargine or detemir) 300 unit/ml are non-formulary
ACTIVE INGREDIENTS	INSULIN,GLARGINE,HUMAN/rDNA STRENGTH: 100 UNITS: UNIT/ML LIXISENATIDE STRENGTH: 33 UNITS: MCG/ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	INSULIN GLARGINE/LIXISENATIDE 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	SOLIQUA 100UNIT/33MCG/ML INJ PEN 3ML
VA PRODUCT IDENTIFIER	S0821
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4036287
EFFECTIVE DATE/TIME	2016-12-26 00:00:00 STATUS: ACTIVE