| NAME |
CORTICOTROPIN 40UNT/ML INJ,GEL |
| VA GENERIC NAME |
CORTICOTROPIN |
| DOSAGE FORM |
INJ |
| FDA MED GUIDE |
Corticotropin_(Acthar Gel)_(2021).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
40 |
| INACTIVATION DATE |
2008-07-01 00:00:00 |
| UNITS |
UNIT/ML |
| DSS NUMBER |
5 |
| NATIONAL FORMULARY NAME |
CORTICOTROPIN INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
CORTICOTROPIN 40 UNT/ML GEL INJ |
| VA PRODUCT IDENTIFIER |
C0519 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4005125 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2008-07-01 00:00:00
- STATUS: INACTIVE
|
