UROFOLLITROPIN 75UNT/VIL INJ (7579)    VA PRODUCT (50.68)

Name Value
NAME UROFOLLITROPIN 75UNT/VIL INJ
VA GENERIC NAME UROFOLLITROPIN
DOSAGE FORM INJ,LYPHL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 75
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2020-04-15 00:00:00
UNITS UNT/VIL
DSS NUMBER 3
NATIONAL FORMULARY NAME UROFOLLITROPIN INJ,LYPHL
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 UROFOLLITROPIN 75 UNT/VIL INJ
VA PRODUCT IDENTIFIER U0033
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4008079
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-27 00:00:00
    STATUS:   INACTIVE
  • 2007-10-10 00:00:00
    STATUS:   ACTIVE
  • 2020-04-15 00:00:00
    STATUS:   INACTIVE