| NAME |
GADOPICLENOL 0.5MMOL/ML INJ SYR,10ML |
| VA GENERIC NAME |
GADOPICLENOL |
| DOSAGE FORM |
INJ |
| FDA MED GUIDE |
Gadopiclenol_(Elucirem)_2022).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
0.5 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MM/ML |
| NATIONAL FORMULARY NAME |
GADOPICLENOL INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2022-12-08 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
GADOPICLENOL 0.5MMOL/ML INJ SYR 10ML |
| VA PRODUCT IDENTIFIER |
G0513 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
SYR |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4041879 |
| EFFECTIVE DATE/TIME |
-
- 2022-12-08 00:00:00
- STATUS: ACTIVE
|
