AMANTADINE 258MG TAB,SA (28554)    VA PRODUCT (50.68)

Name Value
NAME AMANTADINE 258MG TAB,SA
VA GENERIC NAME AMANTADINE
DOSAGE FORM TAB,SA
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 258
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
NATIONAL FORMULARY NAME AMANTADINE TAB,SA
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:   2
    COPAY EFFECTIVE DATE:   2018-06-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME AMANTADINE 258MG SA TAB
VA PRODUCT IDENTIFIER A1978
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4037577
EFFECTIVE DATE/TIME
  • 2018-05-31 00:00:00
    STATUS:   ACTIVE
  • 2018-05-31 00:00:00
    STATUS:   ACTIVE