| NAME |
AMIKACIN LIPOSOME 590MG/8.4ML SUSP,INHL,ORAL |
| VA GENERIC NAME |
AMIKACIN |
| DOSAGE FORM |
SUSP,INHL |
| FDA MED GUIDE |
Amikacin_Liposome_inh_susp_(Arikayce)_(2023).pdf |
| FORMULARY DESIGNATOR |
PA-F |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
590 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/8.4ML |
| NATIONAL FORMULARY NAME |
AMIKACIN SUSP,INHL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2018-10-12 00:00:00
|
| PGX ELIGIBLE |
YES |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
AMIKACIN LIPOSOME 590MG/8.4ML INHL SUSP |
| VA PRODUCT IDENTIFIER |
A1991 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037919 |
| EFFECTIVE DATE/TIME |
-
- 2018-10-15 00:00:00
- STATUS: ACTIVE
|
