| NAME |
SUMATRIPTAN 6.5MG/ACTUATION 4HR IONTOPHORETIC SYSTEM |
| VA GENERIC NAME |
SUMATRIPTAN |
| DOSAGE FORM |
IONTOPHORETIC SYSTEM |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
6.5 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| INACTIVATION DATE |
2016-07-13 00:00:00 |
| UNITS |
MCG/ACTUAT |
| NATIONAL FORMULARY NAME |
SUMATRIPTAN IONTOPHORETIC SYSTEM |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
SUMATRIPTAN 6.5MG/ACTUAT 4HR ION SYSTEM |
| VA PRODUCT IDENTIFIER |
S0784 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4034792 |
| EFFECTIVE DATE/TIME |
-
- 2015-09-10 00:00:00
- STATUS: ACTIVE
|
