DARATUMUMAB 20MG/ML INJ,SOLN (26324)    VA PRODUCT (50.68)

Name Value
NAME DARATUMUMAB 20MG/ML INJ,SOLN
VA GENERIC NAME DARATUMUMAB
DOSAGE FORM INJ,SOLN
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 20
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/ML
NATIONAL FORMULARY NAME DARATUMUMAB INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
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 DARATUMUMAB 20MG/ML SOLN INJ
VA PRODUCT IDENTIFIER D1114
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4035130
EFFECTIVE DATE/TIME
  • 2015-11-27 00:00:00
    STATUS:   ACTIVE