APIXABAN 5MG TAB STARTER PACK,74 (30000)    VA PRODUCT (50.68)

Name Value
NAME APIXABAN 5MG TAB STARTER PACK,74
VA GENERIC NAME APIXABAN
DOSAGE FORM TAB,ORAL
FDA MED GUIDE Apixaban_(Eliquis)_(2021).pdf
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 5
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME APIXABAN TAB,ORAL
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:   3
    COPAY EFFECTIVE DATE:   2020-03-20 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME APIXABAN 5MG TAB STARTER PACK,74
VA PRODUCT IDENTIFIER A2052
TRANSMIT TO CMOP NO
VA DISPENSE UNIT PKT
MASTER ENTRY FOR VUID YES
VUID 4039229
EFFECTIVE DATE/TIME
  • 2020-03-20 00:00:00
    STATUS:   ACTIVE