DONEPEZIL 10MG/MEMANTINE 28MG 24HR CAP,SPRINKLE,SA (25664) VA PRODUCT (50.68)

Name	Value
NAME	DONEPEZIL 10MG/MEMANTINE 28MG 24HR CAP,SPRINKLE,SA
VA GENERIC NAME	DONEPEZIL/MEMANTINE
DOSAGE FORM	CAP,SPRINKLE,SA
ACTIVE INGREDIENTS	DONEPEZIL HYDROCHLORIDE STRENGTH: 10 UNITS: MG MEMANTINE STRENGTH: 28 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	DONEPEZIL/MEMANTINE CAP,SPRINKLE,SA
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	No Possible Dosages
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	NAMZARIC 10MG/28MG 24HR SPRINKLE CAP SA
VA PRODUCT IDENTIFIER	N0709
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4034409
EFFECTIVE DATE/TIME	2015-04-28 00:00:00 STATUS: ACTIVE