| NAME |
CARBIDOPA 4.63MG/ML/LEVODOPA 20MG/ML SUSP,INTESTINAL,100ML,CTR |
| VA GENERIC NAME |
CARBIDOPA/LEVODOPA |
| DOSAGE FORM |
SUSP,INTESTINAL |
| FDA MED GUIDE |
Carbidopa-Levodopa_(Duopa)_(2019).pdf |
| FORMULARY DESIGNATOR |
PA-F |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
CARBIDOPA/LEVODOPA SUSP,INTESTINAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
CARBIDOPA 4.63/LEVO 20MG/ML SUSP,100ML |
| VA PRODUCT IDENTIFIER |
C1694 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4034171 |
| EFFECTIVE DATE/TIME |
-
- 2015-02-13 00:00:00
- STATUS: ACTIVE
|
