| NAME |
INSULIN,GLARGINE,HUMAN 300 UNIT/ML INJ,SOLOSTAR,3ML |
| VA GENERIC NAME |
INSULIN |
| DOSAGE FORM |
INJ |
| FORMULARY DESIGNATOR |
PA-F |
| FORMULARY DESIGNATOR TEXT |
|
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
300 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| INACTIVATION DATE |
2022-11-15 00:00:00 |
| UNITS |
UNIT/ML |
| NATIONAL FORMULARY NAME |
INSULIN INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2018-06-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
INSULIN,GLARGINE 300 UNT/ML 3ML SOLOSTR |
| VA PRODUCT IDENTIFIER |
I0647 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
SYR |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037452 |
| EFFECTIVE DATE/TIME |
-
- 2018-04-16 00:00:00
- STATUS: ACTIVE
-
- 2022-11-15 00:00:00
- STATUS: INACTIVE
|
