PROGESTERONE 8% (90MG) GEL,VAG,APPLICATOR (295)    VA PRODUCT (50.68)

Name Value
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
  • 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 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