CORTICOTROPIN 80UNT/ML INJ,GEL (4579)    VA PRODUCT (50.68)

Name Value
NAME CORTICOTROPIN 80UNT/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 80
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS UNIT/ML
DSS NUMBER 6
NATIONAL FORMULARY NAME CORTICOTROPIN INJ
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME CORTICOTROPIN 80 UNT/ML GEL INJ
VA PRODUCT IDENTIFIER C0521
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4005126
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2008-08-05 00:00:00
    STATUS:   INACTIVE
  • 2008-11-06 00:00:00
    STATUS:   ACTIVE