| NAME |
BELIMUMAB 200MG/ML INJ,PEN,1ML |
| VA GENERIC NAME |
BELIMUMAB |
| DOSAGE FORM |
INJ,SOLN |
| FDA MED GUIDE |
Belimumab_(Benlysta)_(2023).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
200 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/ML |
| NATIONAL FORMULARY NAME |
BELIMUMAB INJ,SOLN |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-09-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
BELIMUMAB 200MG/ML INJ PEN 1ML |
| VA PRODUCT IDENTIFIER |
B0842 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
SYR |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4036866 |
| EFFECTIVE DATE/TIME |
-
- 2017-08-03 00:00:00
- STATUS: ACTIVE
|
