| NAME |
SELEXIPAG 200MCG X 140/800MCG X 60 TAB TITRATION PACK,200 |
| VA GENERIC NAME |
SELEXIPAG |
| DOSAGE FORM |
TAB |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
SELEXIPAG TAB |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2018-05-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
SELEXIPAG 200MCGX140/800MCGX60 TITRATION |
| VA PRODUCT IDENTIFIER |
S0848 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
PKG |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037495 |
| EFFECTIVE DATE/TIME |
-
- 2018-05-01 00:00:00
- STATUS: ACTIVE
|
