ATAZANAVIR SO4 300MG CAP (17991)    VA PRODUCT (50.68)

Name Value
NAME ATAZANAVIR SO4 300MG CAP
VA GENERIC NAME ATAZANAVIR
DOSAGE FORM CAP,ORAL
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT 
Restricted to HIV/ID (or facility designated/authorized provider)
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 300
INACTIVATION DATE 2009-12-01 00:00:00
UNITS MG
NATIONAL FORMULARY NAME ATAZANAVIR CAP,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 ATAZANAVIR SO4 300MG CAP
VA PRODUCT IDENTIFIER A1328
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4025708
EFFECTIVE DATE/TIME
  • 2006-11-29 00:00:00
    STATUS:   ACTIVE
  • 2009-12-01 00:00:00
    STATUS:   INACTIVE