TERIPARATIDE (FORTEO) 250MCG/ML (600MCG) INJ,PEN,2.4ML (30049)    VA PRODUCT (50.68)

Name Value
NAME TERIPARATIDE (FORTEO) 250MCG/ML (600MCG) INJ,PEN,2.4ML
VA GENERIC NAME TERIPARATIDE
DOSAGE FORM INJ,SOLN
FDA MED GUIDE Teriparatide_(Forteo)_(2020).pdf
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 600
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MCG/2.4ML
NATIONAL FORMULARY NAME TERIPARATIDE INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2020-04-03 00:00:00
    COPAY END DATE:   2021-05-19 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2021-05-20 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME FORTEO 250MCG/ML (600MCG) 2.4ML PEN
VA PRODUCT IDENTIFIER F0694
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4039285
EFFECTIVE DATE/TIME
  • 2020-04-03 00:00:00
    STATUS:   ACTIVE
  • 2021-10-18 00:00:00
    STATUS:   INACTIVE
  • 2021-10-18 00:00:00
    STATUS:   INACTIVE
  • 2021-10-18 00:00:00
    STATUS:   INACTIVE
  • 2021-10-18 00:00:00
    STATUS:   INACTIVE
  • 2022-02-25 00:00:00
    STATUS:   ACTIVE