RANIBIZUMAB 0.3MG/0.05ML INJ,OPH,SYRINGE (28434)    VA PRODUCT (50.68)

Name Value
NAME RANIBIZUMAB 0.3MG/0.05ML INJ,OPH,SYRINGE
VA GENERIC NAME RANIBIZUMAB
DOSAGE FORM INJ,SOLN
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR TEXT 
Restricted to ophthalmology/retinal specialists
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 0.3
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/0.05ML
NATIONAL FORMULARY NAME RANIBIZUMAB INJ,SOLN
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:   2018-06-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME RANIBIZUMAB 0.3MG/0.05ML OPH INJ SYRINGE
VA PRODUCT IDENTIFIER R0375
TRANSMIT TO CMOP NO
VA DISPENSE UNIT SYR
MASTER ENTRY FOR VUID YES
VUID 4037443
EFFECTIVE DATE/TIME
  • 2018-04-05 00:00:00
    STATUS:   ACTIVE