DASABUVIR/OMBITASVIR/PARITAPREVIR/RITONAVIR TAB,SA DAILY PACK (27105) VA PRODUCT (50.68)

Name	Value
NAME	DASABUVIR/OMBITASVIR/PARITAPREVIR/RITONAVIR TAB,SA DAILY PACK
VA GENERIC NAME	DASABUVIR/OMBITASVIR/PARITAPREVIR/RITONAVIR
DOSAGE FORM	TAB,SA
FDA MED GUIDE	Ombitasvir-Paritaprevir-Ritonavir_and_Dasabuvir_SA_(Viekira_XR)_(2019).pdf
ACTIVE INGREDIENTS	RITONAVIR STRENGTH: 33.33 UNITS: MG OMBITASVIR STRENGTH: 8.33 UNITS: MG PARITAPREVIR STRENGTH: 50 UNITS: MG DASABUVIR STRENGTH: 200 UNITS: MG
NATIONAL FORMULARY INDICATOR	YES
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2019-06-18 00:00:00
NATIONAL FORMULARY NAME	DASABUVIR/OMBITASVIR/PARITAPREVIR/RITONAVIR TAB,SA
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	VIEKIRA XR SA TAB DAILY PACK
VA PRODUCT IDENTIFIER	V0283
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	PKG
MASTER ENTRY FOR VUID	YES
VUID	4035981
EFFECTIVE DATE/TIME	2016-08-12 00:00:00 STATUS: ACTIVE 2019-06-18 00:00:00 STATUS: INACTIVE 2019-06-18 00:00:00 STATUS: INACTIVE