TESTOSTERONE ENANTHATE 200MG/TESTOSTERONE PROPIONATE 25MG INJ (526) VA PRODUCT (50.68)

Name	Value
NAME	TESTOSTERONE ENANTHATE 200MG/TESTOSTERONE PROPIONATE 25MG INJ
VA GENERIC NAME	TESTOSTERONE
DOSAGE FORM	INJ,SOLN
HAZARDOUS TO DISPOSE	NO
FORMULARY DESIGNATOR	PA-F
ACTIVE INGREDIENTS	TESTOSTERONE PROPIONATE STRENGTH: 25 UNITS: MG TESTOSTERONE ENANTHATE STRENGTH: 200 UNITS: MG
NATIONAL FORMULARY INDICATOR	NO
CS FEDERAL SCHEDULE	Schedule III Non-Narcotics
INACTIVATION DATE	2007-09-25 00:00:00
DSS NUMBER	15
NATIONAL FORMULARY NAME	TESTOSTERONE INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
VA PRINT NAME	TESTOST E 200MG/TESTOST P 25MG/ML INJ
VA PRODUCT IDENTIFIER	T0533
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4001138
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-25 00:00:00 STATUS: INACTIVE