FLUTICASONE 100/UMECLIDINIUM 62.5/VILANTEROL 25MCG/ACTUAT INH,30 (27956)    VA PRODUCT (50.68)

Name Value
NAME FLUTICASONE 100/UMECLIDINIUM 62.5/VILANTEROL 25MCG/ACTUAT INH,30
VA GENERIC NAME FLUTICASONE/UMECLIDINIUM/VILANTEROL
DOSAGE FORM INHL,ORAL
FDA MED GUIDE Fluticasone-Umeclidinium-Vilanterol_(Trelegy_Ellipta)_(2017).pdf
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME FLUTICASONE/UMECLIDINIUM/VILANTEROL INHL,ORAL
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-11-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME TRELEGY ELLIPTA 100/62.5/25MCG INH 30D
VA PRODUCT IDENTIFIER T0967
TRANSMIT TO CMOP YES
VA DISPENSE UNIT INHALER
MASTER ENTRY FOR VUID YES
VUID 4036937
EFFECTIVE DATE/TIME
  • 2017-10-12 00:00:00
    STATUS:   ACTIVE