FORMOTEROL FUM DIHYD 5MCG/MOMETASONE FUR 200MCG INHL,ORAL,8.8GM (29365) VA PRODUCT (50.68)

Name	Value
NAME	FORMOTEROL FUM DIHYD 5MCG/MOMETASONE FUR 200MCG INHL,ORAL,8.8GM
VA GENERIC NAME	FORMOTEROL/MOMETASONE
DOSAGE FORM	INHL,ORAL
FDA MED GUIDE	Formoterol-Mometasone_(Dulera)_(2015).pdf
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	MOMETASONE FUROATE STRENGTH: 200 UNITS: MCG FORMOTEROL FUMARATE DIHYDRATE STRENGTH: 5 UNITS: MCG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	FORMOTEROL/MOMETASONE INHL,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2019-07-03 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	FORMOTEROL 5/MOMETASONE 200MCG 60D INHL
VA PRODUCT IDENTIFIER	F0684
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	INHALER
MASTER ENTRY FOR VUID	YES
VUID	4038520
EFFECTIVE DATE/TIME	2019-07-03 00:00:00 STATUS: ACTIVE 2019-07-03 00:00:00 STATUS: ACTIVE