LEUPROLIDE MESYLATE (CAMCEVI) 42MG (6 MONTH) INJ,EMULSON (31936)    VA PRODUCT (50.68)

Name Value
NAME LEUPROLIDE MESYLATE (CAMCEVI) 42MG (6 MONTH) INJ,EMULSON
VA GENERIC NAME LEUPROLIDE
DOSAGE FORM INJ,EMULSION
HAZARDOUS TO DISPOSE NO
WASTE SORT CODE CHEMO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 42
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME LEUPROLIDE INJ,EMULSION
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:   2022-05-05 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME LEUPROLIDE (CAMCEVI) 42MG (6 MONTH) INJ
VA PRODUCT IDENTIFIER L0895
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4041384
EFFECTIVE DATE/TIME
  • 2022-05-05 00:00:00
    STATUS:   ACTIVE