ADALIMUMAB 40MG/0.8ML INJ,VIAL,KIT (16095)    VA PRODUCT (50.68)

Name Value
NAME ADALIMUMAB 40MG/0.8ML INJ,VIAL,KIT
VA GENERIC NAME ADALIMUMAB
DOSAGE FORM INJ,SOLN
FDA MED GUIDE Adalimumab_(Humira)_(Oct_2018).pdf
HAZARDOUS TO DISPOSE NO
DOT SHIPPING CODE
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT 
Restricted to providers appropriate for prescribing TNF inhibitors
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 40
INACTIVATION DATE 2008-09-03 00:00:00
UNITS MG/0.8ML
NATIONAL FORMULARY NAME ADALIMUMAB INJ,SOLN
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 ADALIMUMAB 40MG/0.8ML INJ VIAL KIT
VA PRODUCT IDENTIFIER A1148
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4016458
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2008-09-03 00:00:00
    STATUS:   INACTIVE