ITRACONAZOLE 100MG CAP (9901) VA PRODUCT (50.68)

Name	Value
NAME	ITRACONAZOLE 100MG CAP
VA GENERIC NAME	ITRACONAZOLE
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	HYDROXYPROPYL METHYLCELLULOSE STARCH TITANIUM DIOXIDE GELATIN SUCROSE D & C RED #28 F D & C BLUE #1 ITRACONAZOLE STRENGTH: 100 UNITS: MG D & C RED #22 POLYETHYLENE GLYCOL 20000 F D & C BLUE #2
CS FEDERAL SCHEDULE	Unscheduled
STRENGTH	100
SINGLE/MULTI SOURCE PRODUCT	Multisource
UNITS	MG
DSS NUMBER	1
NATIONAL FORMULARY NAME	ITRACONAZOLE CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	ITRACONAZOLE 100MG CAP
VA PRODUCT IDENTIFIER	I0141
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4010300
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE