INSULIN,GLARGINE 100 UNIT/ML INJ SEMGLEE (30409)    VA PRODUCT (50.68)

Name Value
NAME INSULIN,GLARGINE 100 UNIT/ML INJ SEMGLEE
VA GENERIC NAME INSULIN
DOSAGE FORM INJ
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR TEXT
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 100
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2022-07-15 00:00:00
UNITS UNIT/ML
NATIONAL FORMULARY NAME INSULIN INJ
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:   2020-09-10 00:00:00
    COPAY END DATE:   2022-05-18 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2022-05-19 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME INSULIN,GLARGINE 100 UNIT/ML INJ SEMGLEE
VA PRODUCT IDENTIFIER I0688
TRANSMIT TO CMOP YES
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4039701
EFFECTIVE DATE/TIME
  • 2020-09-10 00:00:00
    STATUS:   ACTIVE
  • 2020-09-10 00:00:00
    STATUS:   ACTIVE
  • 2020-09-10 00:00:00
    STATUS:   ACTIVE
  • 2022-07-15 00:00:00
    STATUS:   INACTIVE