| NAME |
VENETOCLAX 10MGX14/50MGX7/100MGX21 STARTER PACK,42 |
| VA GENERIC NAME |
VENETOCLAX |
| DOSAGE FORM |
TAB |
| FDA MED GUIDE |
Venetoclax_(Venclexta)_(2022).pdf |
| FORMULARY DESIGNATOR |
PA-F |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
VENETOCLAX TAB |
| 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 |
VENETOCLAX 10MGX14/50MG X7/100MGX21,42 |
| VA PRODUCT IDENTIFIER |
V0277 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035658 |
| EFFECTIVE DATE/TIME |
-
- 2016-04-29 00:00:00
- STATUS: ACTIVE
|
