POMALIDOMIDE 4MG CAP,ORAL (23619)    VA PRODUCT (50.68)

Name Value
NAME POMALIDOMIDE 4MG CAP,ORAL
VA GENERIC NAME POMALIDOMIDE
DOSAGE FORM CAP,ORAL
FDA MED GUIDE Pomalidomide_(Pomalyst)_(2023).pdf
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 4
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME POMALIDOMIDE CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Both Inpatient and Outpatient
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME POMALIDOMIDE 4MG ORAL CAP
VA PRODUCT IDENTIFIER P1027
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4032096
EFFECTIVE DATE/TIME
  • 2013-02-20 00:00:00
    STATUS:   ACTIVE