INDINAVIR SULFATE 333MG CAP (13301)    VA PRODUCT (50.68)

Name Value
NAME INDINAVIR SULFATE 333MG CAP
VA GENERIC NAME INDINAVIR
DOSAGE FORM CAP,ORAL
FORMULARY DESIGNATOR TEXT
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR NO
NATIONAL FORMULARY RESTRICTION 
Refer to HIV/AIDS TAG treatment guidelines
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 333
INACTIVATION DATE 2011-03-02 00:00:00
UNITS MG
NATIONAL FORMULARY NAME INDINAVIR CAP,ORAL
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 INDINAVIR SULFATE 333MG CAP
VA PRODUCT IDENTIFIER I0273
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4013666
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2011-03-02 00:00:00
    STATUS:   INACTIVE