PROGESTERONE 50MG/ML INJ (286)    VA PRODUCT (50.68)

Name Value
NAME PROGESTERONE 50MG/ML INJ
VA GENERIC NAME PROGESTERONE
DOSAGE FORM INJ
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT 
Restricted to non-VA infertility referral/VA infertility Specialist
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR NO
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 50
INACTIVATION DATE 2008-09-02 00:00:00
UNITS MG/ML
DSS NUMBER 2
NATIONAL FORMULARY NAME PROGESTERONE INJ
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
TRANSMIT TO CMOP NO
MASTER ENTRY FOR VUID YES
VUID 4000908
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2008-09-02 00:00:00
    STATUS:   INACTIVE