SEMAGLUTIDE(WT LOSS) 2.4MG/0.75ML INJ,SOLN,PEN,0.75ML (31216)    VA PRODUCT (50.68)

Name Value
NAME SEMAGLUTIDE(WT LOSS) 2.4MG/0.75ML INJ,SOLN,PEN,0.75ML
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 2.4
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/0.75ML
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 2.4MG/0.75ML PEN 0.75ML
VA PRODUCT IDENTIFIER S0927
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040580
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