| NAME |
PEGINTERFERON BETA-1A 63MCG X 1/94MCG X 1 PEN KIT |
| VA GENERIC NAME |
PEGINTERFERON |
| DOSAGE FORM |
INJ,SOLN |
| FDA MED GUIDE |
Peginterferon_Beta-1a_(Plegridy)_(Nov_2021).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
PEGINTERFERON INJ,SOLN |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| 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 |
PEGINTERFERON BETA-1A PEN STARTER KIT |
| VA PRODUCT IDENTIFIER |
P1097 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4033774 |
| EFFECTIVE DATE/TIME |
-
- 2014-10-20 00:00:00
- STATUS: ACTIVE
|
