RASAGILINE MESYLATE 0.5MG TAB (17705)    VA PRODUCT (50.68)

Name Value
NAME RASAGILINE MESYLATE 0.5MG TAB
VA GENERIC NAME RASAGILINE
DOSAGE FORM TAB
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT
Restricted to neurology, movement disorder specialist
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 0.5
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME RASAGILINE 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 RASAGILINE MESYLATE 0.5MG TAB
VA PRODUCT IDENTIFIER R0194
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4025317
EFFECTIVE DATE/TIME
  • 2006-07-20 00:00:00
    STATUS:   ACTIVE