| NAME |
FACTOR IX,RECOMBINANT (THR148) 250 UNIT/VIL INJ |
| VA GENERIC NAME |
FACTOR IX,RECOMBINANT |
| DOSAGE FORM |
INJ |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
250 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
UNT/VIL |
| NATIONAL FORMULARY NAME |
FACTOR IX,RECOMBINANT INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2017-05-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
FACTOR IX,RECOM(THR148) 250UNIT/VIL INJ |
| VA PRODUCT IDENTIFIER |
F0625 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4036550 |
| EFFECTIVE DATE/TIME |
-
- 2017-04-05 00:00:00
- STATUS: ACTIVE
|
