TESTOSTERONE 5MG/24HRS PATCH (534)    VA PRODUCT (50.68)

Name Value
NAME TESTOSTERONE 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 5
INACTIVATION DATE 2002-03-19 00:00:00
UNITS MG/24HRS
DSS NUMBER 24
NATIONAL FORMULARY NAME TESTOSTERONE PATCH
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 TESTOSTERONE 5MG/24HRS PATCH
VA PRODUCT IDENTIFIER T0399
TRANSMIT TO CMOP YES
VA DISPENSE UNIT PATCH
MASTER ENTRY FOR VUID YES
VUID 4001146
EFFECTIVE DATE/TIME
  • 2002-03-19 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE