| NAME |
PIRFENIDONE 801MG TAB,ORAL |
| VA GENERIC NAME |
PIRFENIDONE |
| DOSAGE FORM |
TAB,ORAL |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
801 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
PIRFENIDONE TAB,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-06-01 00:00:00
- COPAY END DATE: 2022-05-12 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2022-05-13 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
PIRFENIDONE 801MG ORAL TAB |
| VA PRODUCT IDENTIFIER |
P1189 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
TAB |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4036604 |
| EFFECTIVE DATE/TIME |
-
- 2017-04-27 00:00:00
- STATUS: ACTIVE
|
