ISONIAZID 150MG/RIFAMPIN 300MG CAP (5116)    VA PRODUCT (50.68)

Name Value
NAME ISONIAZID 150MG/RIFAMPIN 300MG CAP
VA GENERIC NAME ISONIAZID/RIFAMPIN
DOSAGE FORM CAP,ORAL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2021-06-15 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME ISONIAZID/RIFAMPIN CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
    COPAY END DATE:   2021-05-19 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2021-05-20 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME ISONIAZID 150/RIFAMPIN 300MG CAP
VA PRODUCT IDENTIFIER I0126
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4005657
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2021-06-15 00:00:00
    STATUS:   INACTIVE
  • 2021-06-15 00:00:00
    STATUS:   INACTIVE
  • 2021-06-15 00:00:00
    STATUS:   INACTIVE