| NAME |
FOMIVIRSEN NA 6.6MG/ML INJ,OPH,0.25ML |
| VA GENERIC NAME |
FOMIVIRSEN |
| DOSAGE FORM |
INJ,SOLN |
| FORMULARY DESIGNATOR |
R |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
NO |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
6.6 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| INACTIVATION DATE |
2007-09-19 00:00:00 |
| UNITS |
MG/ML |
| NATIONAL FORMULARY NAME |
FOMIVIRSEN INJ,SOLN |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
FOMIVIRSEN 6.6MG/ML OPH INJ 0.25ML |
| VA PRODUCT IDENTIFIER |
F0190 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4013377 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2007-09-19 00:00:00
- STATUS: INACTIVE
|
