| NAME |
EZETIMIBE 10MG/SIMVASTATIN 10MG TAB |
| VA GENERIC NAME |
EZETIMIBE/SIMVASTATIN |
| DOSAGE FORM |
TAB |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR TEXT |
|
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
NO |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
EZETIMIBE/SIMVASTATIN TAB |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
- COPAY END DATE: 2017-06-30 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-07-01 00:00:00
|
| PGX ELIGIBLE |
YES |
| PGX SUPPRESSED |
YES |
| VA PRINT NAME |
EZETIMIBE 10MG/SIMVASTATIN 10MG TAB |
| VA PRODUCT IDENTIFIER |
E0386 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
TAB |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4017240 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
|
