ATOVAQUONE 62.5MG/PROGUANIL HCL 25MG TAB (14573) VA PRODUCT (50.68)

Name	Value
NAME	ATOVAQUONE 62.5MG/PROGUANIL HCL 25MG TAB
VA GENERIC NAME	ATOVAQUONE/PROGUANIL
DOSAGE FORM	TAB
FORMULARY DESIGNATOR TEXT
ACTIVE INGREDIENTS	ATOVAQUONE STRENGTH: 62.5 UNITS: MG PROGUANIL STRENGTH: 25 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	ATOVAQUONE/PROGUANIL 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	ATOVAQUONE 62.5MG/PROGUANIL HCL 25MG TAB
VA PRODUCT IDENTIFIER	A1059
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4014937
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE