| NAME |
BRODALUMAB 210MG/1.5ML INJ,SYR,1.5ML |
| VA GENERIC NAME |
BRODALUMAB |
| DOSAGE FORM |
INJ,SOLN |
| FDA MED GUIDE |
Brodalumab_(Siliq)_(2017).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
210 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
MG/1.5ML |
| NATIONAL FORMULARY NAME |
BRODALUMAB 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: 2017-05-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
BRODALUMAB 210MG/1.5ML INJ 1.5ML SYR |
| VA PRODUCT IDENTIFIER |
B0838 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
SYR |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4036547 |
| EFFECTIVE DATE/TIME |
-
- 2017-04-05 00:00:00
- STATUS: ACTIVE
|
