ABEMACICLIB 100MG TAB,14 (27952)    VA PRODUCT (50.68)

Name Value
NAME ABEMACICLIB 100MG TAB,14
VA GENERIC NAME ABEMACICLIB
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 100
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME ABEMACICLIB TAB
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-11-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME ABEMACICLIB 100MG TAB,14
VA PRODUCT IDENTIFIER A1954
TRANSMIT TO CMOP YES
VA DISPENSE UNIT PKG
MASTER ENTRY FOR VUID YES
VUID 4036940
EFFECTIVE DATE/TIME
  • 2017-10-12 00:00:00
    STATUS:   ACTIVE