| NAME |
INTERFERON BETA-1A 8.8MCG X 6/22MCG X 6 PEN INJ (REBIDOSE) |
| VA GENERIC NAME |
INTERFERON BETA-1A |
| DOSAGE FORM |
INJ,SOLN |
| FDA MED GUIDE |
Interferon_Beta-1a_(Rebif)_(2021).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
INTERFERON BETA-1A 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 |
INTERFERON BETA-1A TITRA PACK (REBIDOSE) |
| VA PRODUCT IDENTIFIER |
I0539 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4032170 |
| EFFECTIVE DATE/TIME |
-
- 2013-02-27 00:00:00
- STATUS: ACTIVE
|
