BENDAMUSTINE HCL 90MG/ML INJ,VIL,2ML (25149)    VA PRODUCT (50.68)

Name Value
NAME BENDAMUSTINE HCL 90MG/ML INJ,VIL,2ML
VA GENERIC NAME BENDAMUSTINE
DOSAGE FORM INJ,SOLN
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT
Restricted to Hematology/Oncology (no associated documents)
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 90
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2016-06-15 00:00:00
UNITS MG/ML
NATIONAL FORMULARY NAME BENDAMUSTINE INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
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 BENDAMUSTINE HCL 90MG/ML INJ VIL 2ML
VA PRODUCT IDENTIFIER B0747
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4033830
EFFECTIVE DATE/TIME
  • 2014-11-12 00:00:00
    STATUS:   ACTIVE