BRIGATINIB 90MG X 7/180MG X 23 TAB KIT (28241)    VA PRODUCT (50.68)

Name Value
NAME BRIGATINIB 90MG X 7/180MG X 23 TAB KIT
VA GENERIC NAME BRIGATINIB
DOSAGE FORM TAB
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME BRIGATINIB TAB
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2018-03-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME BRIGATINIB 90MG X 7/180MG X 23 TAB KIT
VA PRODUCT IDENTIFIER B0856
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4037228
EFFECTIVE DATE/TIME
  • 2018-01-18 00:00:00
    STATUS:   ACTIVE