| NAME |
SEBELIPASE ALFA 2MG/ML INJ,10ML |
| VA GENERIC NAME |
SEBELIPASE ALFA |
| DOSAGE FORM |
INJ,SOLN |
| ACTIVE INGREDIENTS |
|
| STRENGTH |
2 |
| UNITS |
MG/ML |
| NATIONAL FORMULARY NAME |
SEBELIPASE ALFA INJ,SOLN |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
SEBELIPASE ALFA 2MG/ML INJ 10ML |
| VA PRODUCT IDENTIFIER |
S0793 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035228 |
| EFFECTIVE DATE/TIME |
-
- 2015-12-18 00:00:00
- STATUS: ACTIVE
|
