TRIFLURIDINE 15MG/TIPIRACIL 6.14MG TAB (26905)    VA PRODUCT (50.68)

Name Value
NAME TRIFLURIDINE 15MG/TIPIRACIL 6.14MG TAB
VA GENERIC NAME TIPIRACIL/TRIFLURIDINE
DOSAGE FORM TAB
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME TIPIRACIL/TRIFLURIDINE 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 TRIFLURIDINE 15MG/TIPIRACIL 6.14MG TAB
VA PRODUCT IDENTIFIER T0933
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4035761
EFFECTIVE DATE/TIME
  • 2016-06-01 00:00:00
    STATUS:   ACTIVE