| NAME |
FLUTICASONE 115MCG/SALMETEROL 21MCG INHL,ORAL,12GM |
| VA GENERIC NAME |
FLUTICASONE/SALMETEROL |
| DOSAGE FORM |
INHL,ORAL |
| FDA MED GUIDE |
Fluticasone-Salmeterol_(Advair_HFA)_(2017).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
FLUTICASONE/SALMETEROL INHL,ORAL |
| 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: 2023-03-08 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2023-03-09 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
FLUTICASONE 115/SALMET 21MCG 120D INHL |
| VA PRODUCT IDENTIFIER |
F0382 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
INHALER |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4025718 |
| EFFECTIVE DATE/TIME |
-
- 2006-11-29 00:00:00
- STATUS: ACTIVE
|
