AMIODARONE HCL (PACERONE) 100MG TAB,UD (22568)    VA PRODUCT (50.68)

Name Value
NAME AMIODARONE HCL (PACERONE) 100MG TAB,UD
VA GENERIC NAME AMIODARONE
DOSAGE FORM TAB
FDA MED GUIDE Amiodarone_(Pacerone)_(2020).pdf
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 100
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME AMIODARONE TAB
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   1
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
    COPAY END DATE:   2017-12-31 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2018-01-01 00:00:00
    COPAY END DATE:   2018-12-31 00:00:00
  • COPAY TIER LEVEL:   1
    COPAY EFFECTIVE DATE:   2019-01-01 00:00:00
    COPAY END DATE:   2021-12-31 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2022-01-01 00:00:00
    COPAY END DATE:   2022-12-31 00:00:00
  • COPAY TIER LEVEL:   1
    COPAY EFFECTIVE DATE:   2023-01-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME AMIODARONE HCL (PACERONE) 100MG TAB UD
VA PRODUCT IDENTIFIER A1599
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4030875
EFFECTIVE DATE/TIME
  • 2011-08-08 00:00:00
    STATUS:   ACTIVE