| NAME |
CABOTEGRAVIR 600MG/3ML INJ,SUSP,SA,KIT |
| VA GENERIC NAME |
CABOTEGRAVIR |
| DOSAGE FORM |
INJ,SUSP,SA |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR |
PA-F |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
600 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/3ML |
| NATIONAL FORMULARY NAME |
CABOTEGRAVIR INJ,SUSP,SA |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2021-12-30 00:00:00
- COPAY END DATE: 2022-03-16 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2022-03-17 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
CABOTEGRAVIR 600MG/3ML SA SUSP INJ KIT |
| VA PRODUCT IDENTIFIER |
C2018 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4041069 |
| EFFECTIVE DATE/TIME |
-
- 2021-12-30 00:00:00
- STATUS: ACTIVE
|
