| NAME |
GLYCOPYRROLATE 15.6/INDACATEROL 27.5MCG CAP,INHL,60 |
| VA GENERIC NAME |
GLYCOPYRROLATE/INDACATEROL |
| DOSAGE FORM |
CAP,INHL |
| FDA MED GUIDE |
Glycopyrrolate-Indacaterol_Inh_(Utibron)_(2016).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| INACTIVATION DATE |
2021-11-15 00:00:00 |
| NATIONAL FORMULARY NAME |
GLYCOPYRROLATE/INDACATEROL CAP,INHL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
1x Possible Dosage |
| PACKAGE |
Both Inpatient and Outpatient |
| 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 |
GLYCOPYRR15.6/INDACAT 27.5MCG INH CAP 60 |
| VA PRODUCT IDENTIFIER |
G0417 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035066 |
| EFFECTIVE DATE/TIME |
-
- 2015-11-19 00:00:00
- STATUS: ACTIVE
-
- 2017-10-13 00:00:00
- STATUS: ACTIVE
-
- 2021-11-15 00:00:00
- STATUS: INACTIVE
|
