DACLATASVIR 30MG TAB (25913)    VA PRODUCT (50.68)

Name Value
NAME DACLATASVIR 30MG TAB
VA GENERIC NAME DACLATASVIR
DOSAGE FORM TAB
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR NO
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 30
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2020-02-18 00:00:00
UNITS MG
NATIONAL FORMULARY NAME DACLATASVIR TAB
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 DACLATASVIR 30MG TAB
VA PRODUCT IDENTIFIER D1106
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4034684
EFFECTIVE DATE/TIME
  • 2015-08-04 00:00:00
    STATUS:   ACTIVE
  • 2020-02-18 00:00:00
    STATUS:   INACTIVE