| NAME |
INSULIN,LISPRO,HUMAN (EQV-HUMALOG) 75/25 INJ,KWIKPEN,3ML |
| VA GENERIC NAME |
INSULIN |
| DOSAGE FORM |
INJ |
| HAZARDOUS TO DISPOSE |
NO |
| PRIMARY EPA CODE |
D024 -M-CRESOL |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
INSULIN INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2023-03-03 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
INSULIN,LISPRO(EQV-HUMLOG) 75/25 KWIKPEN |
| VA PRODUCT IDENTIFIER |
I0757 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042075 |
| EFFECTIVE DATE/TIME |
-
- 2023-03-03 00:00:00
- STATUS: ACTIVE
|
