IVACAFTOR 94MG/LUMACAFTOR 75MG/PKT GRANULES (32242) VA PRODUCT (50.68)

Name	Value
NAME	IVACAFTOR 94MG/LUMACAFTOR 75MG/PKT GRANULES
VA GENERIC NAME	IVACAFTOR/LUMACAFTOR
DOSAGE FORM	GRANULES
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	IVACAFTOR STRENGTH: 94 UNITS: MG/PKT LUMACAFTOR STRENGTH: 75 UNITS: MG/PKT
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	IVACAFTOR/LUMACAFTOR GRANULES
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	No Possible Dosages
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2022-09-22 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	IVACAFTOR 94/LUMACAFTOR 75MG/PKT GRAN
VA PRODUCT IDENTIFIER	I0748
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	PKT
MASTER ENTRY FOR VUID	YES
VUID	4041714
EFFECTIVE DATE/TIME	2022-09-22 00:00:00 STATUS: ACTIVE