| NAME |
COLESEVELAM HCL 3.75GM PWDR,PKT |
| VA GENERIC NAME |
COLESEVELAM |
| DOSAGE FORM |
POWDER,ORAL |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
3.75 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
GM/PKT |
| NATIONAL FORMULARY NAME |
COLESEVELAM POWDER,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: 2018-07-25 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2018-07-26 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
COLESEVELAM HCL 3.75GM PWDR,PKT |
| VA PRODUCT IDENTIFIER |
C1425 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4029663 |
| EFFECTIVE DATE/TIME |
-
- 2010-03-09 00:00:00
- STATUS: ACTIVE
|
