TESTOSTERONE 2.5MG/24HRS PATCH (532)    VA PRODUCT (50.68)

Name Value
NAME TESTOSTERONE 2.5MG/24HRS PATCH
VA GENERIC NAME TESTOSTERONE
DOSAGE FORM PATCH
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Schedule III Non-Narcotics
STRENGTH 2.5
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2016-10-21 00:00:00
UNITS MG/24HRS
DSS NUMBER 22
NATIONAL FORMULARY NAME TESTOSTERONE PATCH
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
VA PRINT NAME TESTOSTERONE 2.5MG/24HRS PATCH
VA PRODUCT IDENTIFIER T0624
TRANSMIT TO CMOP YES
VA DISPENSE UNIT PATCH
MASTER ENTRY FOR VUID YES
VUID 4001144
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE