VALACYCLOVIR HCL 500MG TAB (12481)    VA PRODUCT (50.68)

Name Value
NAME VALACYCLOVIR HCL 500MG TAB
VA GENERIC NAME VALACYCLOVIR
DOSAGE FORM TAB
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
NATIONAL FORMULARY RESTRICTION
Refer to HIV/AIDS TAG treatment guidelines
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 500
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
DSS NUMBER 1
NATIONAL FORMULARY NAME VALACYCLOVIR TAB
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME VALACYCLOVIR HCL 500MG TAB
VA PRODUCT IDENTIFIER V0058
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4012847
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE