| NAME |
TESTOSTERONE 75MG PELLET |
| VA GENERIC NAME |
TESTOSTERONE |
| DOSAGE FORM |
PELLET |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule III Non-Narcotics |
| STRENGTH |
75 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG |
| DSS NUMBER |
13 |
| NATIONAL FORMULARY NAME |
TESTOSTERONE PELLET |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| VA PRINT NAME |
TESTOSTERONE 75MG PELLET |
| VA PRODUCT IDENTIFIER |
T0760 |
| TRANSMIT TO CMOP |
NO |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4001136 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
|
