| NAME |
CERTOLIZUMAB PEGOL 200MG/ML INJ,SOLN,SYR,STARTER KIT,6 |
| VA GENERIC NAME |
CERTOLIZUMAB |
| DOSAGE FORM |
INJ,SOLN |
| FDA MED GUIDE |
Certolizumab_(Cimzia)_(2019).pdf |
| 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 |
200 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/ML |
| NATIONAL FORMULARY NAME |
CERTOLIZUMAB INJ,SOLN |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
CERTOLIZUMAB 200MG/ML SYR STARTER KIT,6 |
| VA PRODUCT IDENTIFIER |
C1497 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4031083 |
| EFFECTIVE DATE/TIME |
-
- 2011-11-04 00:00:00
- STATUS: ACTIVE
|
