VALGANCICLOVIR HCL 450MG TAB (15129)    VA PRODUCT (50.68)

Name Value
NAME VALGANCICLOVIR HCL 450MG TAB
VA GENERIC NAME VALGANCICLOVIR
DOSAGE FORM TAB
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT
Restricted to ID and transplant providers
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 450
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME VALGANCICLOVIR 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 VALGANCICLOVIR HCL 450MG TAB
VA PRODUCT IDENTIFIER V0106
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4015493
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE