| NAME |
TESTOSTERONE UNDECANOATE 112.5MG CAP |
| VA GENERIC NAME |
TESTOSTERONE |
| DOSAGE FORM |
CAP,ORAL |
| FDA MED GUIDE |
Testosterone_Cap_(Tlando)_(2022).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule III Non-Narcotics |
| STRENGTH |
112.5 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| INACTIVATION DATE |
2022-11-15 00:00:00 |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
TESTOSTERONE CAP,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2022-04-14 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
TESTOSTERONE UNDECANOATE 112.5MG CAP |
| VA PRODUCT IDENTIFIER |
T1107 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
CAP |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4041336 |
| EFFECTIVE DATE/TIME |
-
- 2022-04-14 00:00:00
- STATUS: ACTIVE
-
- 2022-11-15 00:00:00
- STATUS: INACTIVE
|
