RIBOCICLIB 200MG TAB,42 (400MG) DAILY PKT (27592)    VA PRODUCT (50.68)

Name Value
NAME RIBOCICLIB 200MG TAB,42 (400MG) DAILY PKT
VA GENERIC NAME RIBOCICLIB
DOSAGE FORM TAB
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT
Restricted to Hematology/Oncology
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 200
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME RIBOCICLIB TAB
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:   2017-05-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME RIBOCICLIB 200MG TAB,42 (400MG)DAILY PKT
VA PRODUCT IDENTIFIER R0361
TRANSMIT TO CMOP NO
VA DISPENSE UNIT PKT
MASTER ENTRY FOR VUID YES
VUID 4036513
EFFECTIVE DATE/TIME
  • 2017-03-24 00:00:00
    STATUS:   ACTIVE