FORMOTEROL FUM 4.8MCG/GLYCOPYRROLATE 9MCG/SPRAY INHL,ORAL,5.9GM (28311) VA PRODUCT (50.68)

Name	Value
NAME	FORMOTEROL FUM 4.8MCG/GLYCOPYRROLATE 9MCG/SPRAY INHL,ORAL,5.9GM
VA GENERIC NAME	FORMOTEROL/GLYCOPYRROLATE
DOSAGE FORM	INHL,ORAL
FDA MED GUIDE	Formoterol-Glycopyrrolate_(Bevespi)_(2016).pdf
ACTIVE INGREDIENTS	GLYCOPYRROLATE STRENGTH: 9 UNITS: MCG FORMOTEROL FUMARATE STRENGTH: 4.8 UNITS: MCG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2022-10-17 00:00:00
NATIONAL FORMULARY NAME	FORMOTEROL/GLYCOPYRROLATE INHL,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2018-04-01 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	FORMOTEROL 4.8/GLYCOPY 9MCG 28D PO INHL
VA PRODUCT IDENTIFIER	F0653
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4037305
EFFECTIVE DATE/TIME	2018-02-13 00:00:00 STATUS: ACTIVE 2022-10-17 00:00:00 STATUS: INACTIVE