| NAME |
FLUTICASONE 100/UMECLIDINIUM 62.5/VILANTEROL 25MCG/ACTUAT INH,14 |
| 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 |
|
| 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 14D |
| VA PRODUCT IDENTIFIER |
T0968 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
INHALER |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4036938 |
| EFFECTIVE DATE/TIME |
-
- 2017-10-12 00:00:00
- STATUS: ACTIVE
|
