ANTIHEMOPHILIC FACTOR,RECOMB,PEGYLATED 1000UNIT/VIL INJ (26373)    VA PRODUCT (50.68)

Name Value
NAME ANTIHEMOPHILIC FACTOR,RECOMB,PEGYLATED 1000UNIT/VIL INJ
VA GENERIC NAME ANTIHEMOPHILIC FACTOR
DOSAGE FORM INJ,LYPHL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 1000
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS UNIT/VIL
NATIONAL FORMULARY NAME ANTIHEMOPHILIC FACTOR INJ
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 ANTIHEMO FACT PEGYLATED 1000UNIT/VI INJ
VA PRODUCT IDENTIFIER A1862
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4035183
EFFECTIVE DATE/TIME
  • 2015-12-10 00:00:00
    STATUS:   ACTIVE