IVACAFTOR 125MG/LUMACAFTOR 200MG TAB (25855) VA PRODUCT (50.68)

Name	Value
NAME	IVACAFTOR 125MG/LUMACAFTOR 200MG TAB
VA GENERIC NAME	IVACAFTOR/LUMACAFTOR
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	IVACAFTOR STRENGTH: 125 UNITS: MG LUMACAFTOR STRENGTH: 200 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	IVACAFTOR/LUMACAFTOR TAB
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	IVACAFTOR 125MG/LUMACAFTOR 200MG TAB
VA PRODUCT IDENTIFIER	I0601
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4034619
EFFECTIVE DATE/TIME	2015-07-17 00:00:00 STATUS: ACTIVE