| NAME |
TREPROSTINIL 0.125MG X126/0.25MG X42 TITRATION PACK,168 |
| VA GENERIC NAME |
TREPROSTINIL |
| DOSAGE FORM |
TAB,SA |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
TREPROSTINIL TAB,SA |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2023-03-02 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ORENITRAM MONTH 1 TITRATION KIT,168 |
| VA PRODUCT IDENTIFIER |
O0444 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042071 |
| EFFECTIVE DATE/TIME |
-
- 2023-03-02 00:00:00
- STATUS: ACTIVE
|
