FORMOTEROL FUM DIHYD 5MCG/MOMETASONE FUR 100MCG INHL,ORAL,13GM (21838) VA PRODUCT (50.68)

Name	Value
NAME	FORMOTEROL FUM DIHYD 5MCG/MOMETASONE FUR 100MCG INHL,ORAL,13GM
VA GENERIC NAME	FORMOTEROL/MOMETASONE
DOSAGE FORM	INHL,ORAL
FDA MED GUIDE	Formoterol-Mometasone_(Dulera)_(2015).pdf
ACTIVE INGREDIENTS	MOMETASONE FUROATE STRENGTH: 100 UNITS: MCG/ACTUAT FORMOTEROL FUMARATE DIHYDRATE STRENGTH: 5 UNITS: MCG/ACTUAT
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	FORMOTEROL/MOMETASONE INHL,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	FORMOTEROL 5/MOMETASONE 100MCG 120D INHL
VA PRODUCT IDENTIFIER	F0471
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	INHALER
MASTER ENTRY FOR VUID	YES
VUID	4030030
EFFECTIVE DATE/TIME	2010-08-13 00:00:00 STATUS: ACTIVE