BUDESONIDE 160/GLYCOPYR 9/FORMOTER 4.8MCG/ACT INHL,ORAL,5.9GM (30336) VA PRODUCT (50.68)

Name	Value
NAME	BUDESONIDE 160/GLYCOPYR 9/FORMOTER 4.8MCG/ACT INHL,ORAL,5.9GM
VA GENERIC NAME	BUDESONIDE/GLYCOPYRROLATE/FORMOTEROL
DOSAGE FORM	INHL,ORAL
HAZARDOUS TO DISPOSE	NO
FORMULARY DESIGNATOR	PA-F
ACTIVE INGREDIENTS	GLYCOPYRROLATE STRENGTH: 9 UNITS: MCG/INHL BUDESONIDE STRENGTH: 160 UNITS: MCG/INHL FLUTICASONE FUROATE STRENGTH: 4.8 UNITS: MCG/INHL
NATIONAL FORMULARY INDICATOR	YES
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	BUDESONIDE/GLYCOPYRROLATE/FORMOTEROL INHL,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2020-08-14 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	BREZTRI 160/9/4.8MCG/ACT 28D ORAL INHL
VA PRODUCT IDENTIFIER	B0907
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	INHALER
MASTER ENTRY FOR VUID	YES
VUID	4039615
EFFECTIVE DATE/TIME	2020-08-14 00:00:00 STATUS: ACTIVE 2020-08-14 00:00:00 STATUS: ACTIVE