ANTIHEMOPHILIC FACTOR,RECOMBINANT 1500UNIT/VIL INJ,KIT (25580)    VA PRODUCT (50.68)

Name Value
NAME ANTIHEMOPHILIC FACTOR,RECOMBINANT 1500UNIT/VIL INJ,KIT
VA GENERIC NAME ANTIHEMOPHILIC FACTOR
DOSAGE FORM INJ,LYPHL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 1500
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS UNIT/VIL
NATIONAL FORMULARY NAME ANTIHEMOPHILIC FACTOR INJ,LYPHL
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME ANTIHEMOPHILIC FACTOR 1500UNIT/VIL INJ
VA PRODUCT IDENTIFIER A1798
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4034313
EFFECTIVE DATE/TIME
  • 2015-03-20 00:00:00
    STATUS:   ACTIVE