MEMANTINE HCL 14MG CAP,SA,UD (23854)    VA PRODUCT (50.68)

Name Value
NAME MEMANTINE HCL 14MG CAP,SA,UD
VA GENERIC NAME MEMANTINE
DOSAGE FORM CAP,SA
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 14
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2016-10-03 00:00:00
UNITS MG
NATIONAL FORMULARY NAME MEMANTINE CAP,SA
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 MEMANTINE HCL 14MG SA CAP UD
VA PRODUCT IDENTIFIER M0998
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4032362
EFFECTIVE DATE/TIME
  • 2013-05-15 00:00:00
    STATUS:   ACTIVE