SOFOSBUVIR 400MG/VELPATASVIR 100MG/VOXILAPREVIR 100MG TAB (27902) VA PRODUCT (50.68)

Name	Value
NAME	SOFOSBUVIR 400MG/VELPATASVIR 100MG/VOXILAPREVIR 100MG TAB
VA GENERIC NAME	SOFOSBUVIR/VELPATASVIR/VOXILAPREVIR
DOSAGE FORM	TAB,ORAL
FORMULARY DESIGNATOR	PA-F
ACTIVE INGREDIENTS	SOFOSBUVIR STRENGTH: 400 UNITS: MG VELPATASVIR STRENGTH: 100 UNITS: MG VOXILAPREVIR STRENGTH: 100 UNITS: MG
NATIONAL FORMULARY INDICATOR	YES
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	SOFOSBUVIR/VELPATASVIR/VOXILAPREVIR TAB,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	1x Possible Dosage
PACKAGE	Both Inpatient and Outpatient
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-09-01 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	VOSEVI TAB
VA PRODUCT IDENTIFIER	V0287
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4036868
EFFECTIVE DATE/TIME	2017-08-03 00:00:00 STATUS: ACTIVE