SEMAGLUTIDE(WT LOSS) 1MG/0.5ML INJ,SOLN,PEN,0.5ML (31214)    VA PRODUCT (50.68)

Name Value
NAME SEMAGLUTIDE(WT LOSS) 1MG/0.5ML INJ,SOLN,PEN,0.5ML
VA GENERIC NAME SEMAGLUTIDE
DOSAGE FORM INJ,SOLN
FDA MED GUIDE Semaglutide_(Wegovy)_(2022).pdf
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR TEXT
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 1
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/0.5ML
NATIONAL FORMULARY NAME SEMAGLUTIDE INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2021-06-17 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME SEMAGLUTIDE WL 1MG/0.5ML PEN 0.5ML
VA PRODUCT IDENTIFIER S0925
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040578
EFFECTIVE DATE/TIME
  • 2021-06-17 00:00:00
    STATUS:   ACTIVE
  • 2021-06-17 00:00:00
    STATUS:   ACTIVE
  • 2021-06-17 00:00:00
    STATUS:   ACTIVE