| NAME |
ESOMEPRAZOLE MAGNESIUM 20MG/NAPROXEN 500MG TAB,EC |
| VA GENERIC NAME |
ESOMEPRAZOLE/NAPROXEN |
| DOSAGE FORM |
TAB,EC |
| FDA MED GUIDE |
Esomeprazole-Naproxen_(Generic)_(2021).pdf |
| FORMULARY DESIGNATOR |
PA-F |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
ESOMEPRAZOLE/NAPROXEN TAB,EC |
| 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: 2020-03-04 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2020-03-05 00:00:00
|
| PGX ELIGIBLE |
YES |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ESOMEPRAZOLE 20MG/NAPROXEN 500MG EC TAB |
| VA PRODUCT IDENTIFIER |
E0544 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
TAB |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4030076 |
| EFFECTIVE DATE/TIME |
-
- 2010-09-08 00:00:00
- STATUS: ACTIVE
|
