| NAME |
RABEPRAZOLE NA 10MG CAP,SPRINKLE |
| VA GENERIC NAME |
RABEPRAZOLE |
| DOSAGE FORM |
CAP,SPRINKLE |
| FDA MED GUIDE |
Rabeprazole_Cap_(Generic)_(2019).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
10 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
RABEPRAZOLE CAP,SPRINKLE |
| 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: 2019-07-17 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2019-07-18 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
RABEPRAZOLE NA 10MG SPRINKLE CAP |
| VA PRODUCT IDENTIFIER |
R0326 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
CAP |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4032850 |
| EFFECTIVE DATE/TIME |
-
- 2013-11-18 00:00:00
- STATUS: ACTIVE
|
