| NAME |
DABIGATRAN ETEXILATE 30MG PELLET PKT |
| VA GENERIC NAME |
DABIGATRAN |
| DOSAGE FORM |
PELLET |
| FDA MED GUIDE |
Dabigatran_Pellets_(Pradaxa)_(2022).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
30 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
DABIGATRAN PELLET |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2023-02-23 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DABIGATRAN ETEXILATE 30MG PELLET PKT |
| VA PRODUCT IDENTIFIER |
D1309 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042038 |
| EFFECTIVE DATE/TIME |
-
- 2023-02-23 00:00:00
- STATUS: ACTIVE
|
