FORMOTEROL FUM DIHYD 5MCG/MOMETASONE FUR 50MCG INHL,ORAL,13GM (29901) VA PRODUCT (50.68)

Name	Value
NAME	FORMOTEROL FUM DIHYD 5MCG/MOMETASONE FUR 50MCG INHL,ORAL,13GM
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: 50 UNITS: MCG/ACTUAT FORMOTEROL FUMARATE DIHYDRATE STRENGTH: 5 UNITS: MCG/ACTUAT
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: 2020-02-06 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	FORMOTEROL 5/MOMETASONE 50MCG 120D INHL
VA PRODUCT IDENTIFIER	F0692
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	INHALER
MASTER ENTRY FOR VUID	YES
VUID	4039122
EFFECTIVE DATE/TIME	2020-02-06 00:00:00 STATUS: ACTIVE