| NAME |
TERIPARATIDE 250MCG/ML (620MCG) INJ,PEN,2.48ML |
| VA GENERIC NAME |
TERIPARATIDE |
| DOSAGE FORM |
INJ,SOLN |
| FDA MED GUIDE |
Teriparatide_(generic)_(2019).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR |
PA-F |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
620 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MCG/2.48ML |
| NATIONAL FORMULARY NAME |
TERIPARATIDE INJ,SOLN |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2020-04-03 00:00:00
- COPAY END DATE: 2020-07-15 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2020-07-16 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
TERIPARATIDE 250MCG/ML (620MCG) 2.48ML |
| VA PRODUCT IDENTIFIER |
T1062 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4039286 |
| EFFECTIVE DATE/TIME |
-
- 2020-04-03 00:00:00
- STATUS: ACTIVE
|
