| NAME |
PATIROMER CALCIUM SORBITEX 25.2GM/PKT POWDER,ORAL |
| VA GENERIC NAME |
PATIROMER CALCIUM SORBITEX |
| DOSAGE FORM |
PWDR,RENST-ORAL |
| FORMULARY DESIGNATOR |
PA-F |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
25.2 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
GM/PKT |
| NATIONAL FORMULARY NAME |
PATIROMER CALCIUM SORBITEX PWDR,RENST-ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
PATIROMER CA SORBITEX 25.2GM/PKT ORAL |
| VA PRODUCT IDENTIFIER |
P1158 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035199 |
| EFFECTIVE DATE/TIME |
-
- 2015-12-11 00:00:00
- STATUS: ACTIVE
|
