| NAME |
TRIPTORELIN PAMOATE (PEDIATRIC) 22.5MG/KIT INJ,SUSP,SA |
| VA GENERIC NAME |
TRIPTORELIN |
| DOSAGE FORM |
INJ,SUSP,SA |
| FDA MED GUIDE |
Triptorelin_(Triptodur)_(Dec_2022).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
22.5 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/VIAL |
| NATIONAL FORMULARY NAME |
TRIPTORELIN INJ,SUSP,SA |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2018-06-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
TRIPTORELIN (PED) 22.5MG/KIT SUSP SA INJ |
| VA PRODUCT IDENTIFIER |
T0981 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037484 |
| EFFECTIVE DATE/TIME |
-
- 2018-04-20 00:00:00
- STATUS: ACTIVE
|
