| NAME |
MOXETUMOMAB PASUDOTOX-TDFK 1MG/VIL INJ |
| VA GENERIC NAME |
MOXETUMOMAB PASUDOTOX-TDFK |
| DOSAGE FORM |
INJ,LYPHL |
| FDA MED GUIDE |
Moxetumomab-tdfk_(Lumoxiti)_(2020).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
1 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/VIAL |
| NATIONAL FORMULARY NAME |
MOXETUMOMAB PASUDOTOX-TDFK INJ,LYPHL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2018-10-25 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
MOXETUMOMAB PASUDOTOX-TDFK 1MG/VIL INJ |
| VA PRODUCT IDENTIFIER |
M1199 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037936 |
| EFFECTIVE DATE/TIME |
-
- 2018-10-25 00:00:00
- STATUS: ACTIVE
|
