| NAME |
EMICIZUMAB-KXWH 150MG/ML INJ,SOLN,0.4ML |
| VA GENERIC NAME |
EMICIZUMAB |
| DOSAGE FORM |
INJ,SOLN |
| FDA MED GUIDE |
Emicizumab-kxwh_(Hemlibra)_(2021).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
150 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
MG/ML |
| NATIONAL FORMULARY NAME |
EMICIZUMAB INJ,SOLN |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2018-01-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
EMICIZUMAB-KXWH 150MG/ML 0.4ML INJ |
| VA PRODUCT IDENTIFIER |
E0726 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037125 |
| EFFECTIVE DATE/TIME |
-
- 2017-12-01 00:00:00
- STATUS: ACTIVE
|
