ENTECAVIR 0.25MG/5ML SOLN,ORAL (17202)    VA PRODUCT (50.68)

Name Value
NAME ENTECAVIR 0.25MG/5ML SOLN,ORAL
VA GENERIC NAME ENTECAVIR
DOSAGE FORM SOLN,ORAL
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT
Restricted to ID, GI, Oncology, Rheumatology or providers who care for HBV
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 0.25
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/5ML
NATIONAL FORMULARY NAME ENTECAVIR SOLN,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 ENTECAVIR 0.25MG/5ML ORAL SOLN
VA PRODUCT IDENTIFIER E0414
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4024634
EFFECTIVE DATE/TIME
  • 2006-01-24 00:00:00
    STATUS:   ACTIVE