VENLAFAXINE HCL 100MG TAB (11814)    VA PRODUCT (50.68)

Name Value
NAME VENLAFAXINE HCL 100MG TAB
VA GENERIC NAME VENLAFAXINE
DOSAGE FORM TAB
FDA MED GUIDE Venlafaxine_Tab_(Generic)_(2021).pdf
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 100
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
DSS NUMBER 5
NATIONAL FORMULARY NAME VENLAFAXINE TAB
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Both Inpatient and Outpatient
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   1
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
    COPAY END DATE:   2019-12-31 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2020-01-01 00:00:00
    COPAY END DATE:   2020-12-31 00:00:00
  • COPAY TIER LEVEL:   1
    COPAY EFFECTIVE DATE:   2021-01-01 00:00:00
PGX ELIGIBLE YES
PGX SUPPRESSED NO
VA PRINT NAME VENLAFAXINE HCL 100MG TAB
VA PRODUCT IDENTIFIER V0052
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4012180
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE