DARUNAVIR ETHANOLATE 150MG TAB (22700)    VA PRODUCT (50.68)

Name Value
NAME DARUNAVIR ETHANOLATE 150MG TAB
VA GENERIC NAME DARUNAVIR
DOSAGE FORM TAB
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT
Restricted to HIV/ID (or facility designated/authorized provider)
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 150
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME DARUNAVIR TAB
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 DARUNAVIR ETHANOLATE 150MG TAB
VA PRODUCT IDENTIFIER D0907
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4031035
EFFECTIVE DATE/TIME
  • 2011-10-11 00:00:00
    STATUS:   ACTIVE