BEMPEDOIC ACID 180MG/EZETIMIBE 10MG TAB,ORAL (30173) VA PRODUCT (50.68)

Name	Value
NAME	BEMPEDOIC ACID 180MG/EZETIMIBE 10MG TAB,ORAL
VA GENERIC NAME	BEMPEDOIC ACID/EZETIMIBE
DOSAGE FORM	TAB,ORAL
HAZARDOUS TO DISPOSE	NO
FORMULARY DESIGNATOR TEXT
ACTIVE INGREDIENTS	EZETIMIBE STRENGTH: 10 UNITS: MG BEMPEDOIC ACID STRENGTH: 180 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	BEMPEDOIC ACID/EZETIMIBE TAB,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2020-06-04 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	BEMPEDOIC ACID 180MG/EZETIMIBE 10MG TAB
VA PRODUCT IDENTIFIER	B0897
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4039429
EFFECTIVE DATE/TIME	2020-06-04 00:00:00 STATUS: ACTIVE