OSIMERTINIB 40MG TAB (26321)    VA PRODUCT (50.68)

Name Value
NAME OSIMERTINIB 40MG TAB
VA GENERIC NAME OSIMERTINIB
DOSAGE FORM TAB
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 40
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME OSIMERTINIB TAB
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 OSIMERTINIB 40MG TAB
VA PRODUCT IDENTIFIER O0371
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4035127
EFFECTIVE DATE/TIME
  • 2015-11-27 00:00:00
    STATUS:   ACTIVE