| NAME |
TRIAMCINOLONE ACETONIDE (EQV-TRIESENCE) 40MG/ML INJ,SUSP,OPH |
| VA GENERIC NAME |
TRIAMCINOLONE |
| DOSAGE FORM |
INJ,SUSP |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR |
PA-F |
| FORMULARY DESIGNATOR TEXT |
RESTRICTED TO OPHTHALMOLOGY
|
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
40 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/ML |
| NATIONAL FORMULARY NAME |
TRIAMCINOLONE INJ,SUSP |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2023-02-06 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
TRIAMCINOLONE (EQV-TRIESENCE)40MG/ML OPH |
| VA PRODUCT IDENTIFIER |
T1138 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042006 |
| EFFECTIVE DATE/TIME |
-
- 2023-02-06 00:00:00
- STATUS: ACTIVE
|
