| NAME |
ESOMEPRAZOLE MAGNESIUM 5MG/PKT PWDR,ORAL |
| VA GENERIC NAME |
ESOMEPRAZOLE |
| DOSAGE FORM |
PWDR,RENST-ORAL |
| FDA MED GUIDE |
Esomeprazole_Magnesium_Powder_(Generic)_(2021).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
5 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/PKT |
| NATIONAL FORMULARY NAME |
ESOMEPRAZOLE PWDR,RENST-ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-05-01 00:00:00
|
| PGX ELIGIBLE |
YES |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ESOMEPRAZOLE MAG 5MG/PKT ORAL PWDR |
| VA PRODUCT IDENTIFIER |
E0705 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4036503 |
| EFFECTIVE DATE/TIME |
-
- 2017-03-22 00:00:00
- STATUS: ACTIVE
|
