| NAME |
FREMANEZUMAB-VFRM 225MG/1.5ML INJ,SYRINGE,1.5ML |
| VA GENERIC NAME |
FREMANEZUMAB-VFRM |
| DOSAGE FORM |
INJ,SOLN |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
225 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/1.5ML |
| NATIONAL FORMULARY NAME |
FREMANEZUMAB-VFRM INJ,SOLN |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2018-09-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
FREMANEZUMAB-VFRM 225MG/1.5ML SYR 1.5ML |
| VA PRODUCT IDENTIFIER |
F0669 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
SYR |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037849 |
| EFFECTIVE DATE/TIME |
-
- 2018-09-27 00:00:00
- STATUS: ACTIVE
|
