RALTEGRAVIR 100MG TAB,CHEWABLE (23589)    VA PRODUCT (50.68)

Name Value
NAME RALTEGRAVIR 100MG TAB,CHEWABLE
VA GENERIC NAME RALTEGRAVIR
DOSAGE FORM TAB,CHEWABLE
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR NO
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 100
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
NATIONAL FORMULARY NAME RALTEGRAVIR TAB,CHEWABLE
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 RALTEGRAVIR 100MG CHEWABLE TAB
VA PRODUCT IDENTIFIER R0308
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4032063
EFFECTIVE DATE/TIME
  • 2013-02-19 00:00:00
    STATUS:   ACTIVE