AZACITIDINE 100MG/VI INJ,SUSP (16742)    VA PRODUCT (50.68)

Name Value
NAME AZACITIDINE 100MG/VI INJ,SUSP
VA GENERIC NAME AZACITIDINE
DOSAGE FORM INJ,SUSP
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 100
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/VIAL
NATIONAL FORMULARY NAME AZACITIDINE INJ,LYPHL
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 AZACITIDINE 100MG/VI SUSP INJ
VA PRODUCT IDENTIFIER A1216
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4017105
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE