NAME |
PROGESTERONE 8% (90MG) GEL,VAG,APPLICATOR |
VA GENERIC NAME |
PROGESTERONE |
DOSAGE FORM |
GEL,VAG |
FORMULARY DESIGNATOR |
PA-F |
FORMULARY DESIGNATOR TEXT |
Restricted to non-VA infertility referral/VA infertility Specialist
|
ACTIVE INGREDIENTS |
|
NATIONAL FORMULARY INDICATOR |
YES |
CS FEDERAL SCHEDULE |
Unscheduled |
STRENGTH |
8 |
SINGLE/MULTI SOURCE PRODUCT |
Single source |
UNITS |
% |
DSS NUMBER |
11 |
NATIONAL FORMULARY NAME |
PROGESTERONE GEL,VAG |
CREATE DEFAULT POSSIBLE DOSAGE |
YES |
CODING SYSTEM |
|
COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
VA PRINT NAME |
PROGESTERONE 8% (90MG) VAG GEL APPLICATR |
VA PRODUCT IDENTIFIER |
P0458 |
TRANSMIT TO CMOP |
NO |
VA DISPENSE UNIT |
EA |
MASTER ENTRY FOR VUID |
YES |
VUID |
4000917 |
EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2007-09-27 00:00:00
- STATUS: INACTIVE
-
- 2007-10-10 00:00:00
- STATUS: ACTIVE
|