ALGLUCOSIDASE ALFA 50MG/VIL INJ (17657)    VA PRODUCT (50.68)

Name Value
NAME ALGLUCOSIDASE ALFA 50MG/VIL INJ
VA GENERIC NAME ALGLUCOSIDASE
DOSAGE FORM INJ,LYPHL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 50
INACTIVATION DATE 2010-09-20 00:00:00
UNITS MG/VIAL
NATIONAL FORMULARY NAME ALGLUCOSIDASE 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 ALGLUCOSIDASE ALFA 50MG/VIL INJ
VA PRODUCT IDENTIFIER A1306
TRANSMIT TO CMOP YES
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4025189
EFFECTIVE DATE/TIME
  • 2006-05-22 00:00:00
    STATUS:   ACTIVE
  • 2010-09-20 00:00:00
    STATUS:   INACTIVE