| NAME |
DULAGLUTIDE 4.5MG/0.5ML INJ,SOLN,PEN |
| VA GENERIC NAME |
DULAGLUTIDE |
| DOSAGE FORM |
INJ,SOLN |
| FDA MED GUIDE |
Dulaglutide_(Trulicity)_(2022).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
4.5 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/0.5ML |
| NATIONAL FORMULARY NAME |
DULAGLUTIDE 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: 2020-09-22 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DULAGLUTIDE 4.5MG/0.5ML INJ PEN |
| VA PRODUCT IDENTIFIER |
D1249 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4039708 |
| EFFECTIVE DATE/TIME |
-
- 2020-09-22 00:00:00
- STATUS: ACTIVE
-
- 2020-09-22 00:00:00
- STATUS: ACTIVE
-
- 2020-09-22 00:00:00
- STATUS: ACTIVE
|
