| NAME |
RISANKIZUMAB-RZAA 75MG/0.83ML X 2 INJ,SYRINGE,KIT |
| VA GENERIC NAME |
RISANKIZUMAB-RZAA |
| DOSAGE FORM |
INJ,SOLN |
| FDA MED GUIDE |
Risankizumab-rzaa_(Skyrizi)_(Sep_2022).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
75 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/0.83ML |
| NATIONAL FORMULARY NAME |
RISANKIZUMAB-RZAA 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: 2019-05-09 00:00:00
- COPAY END DATE: 2023-03-29 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2023-03-30 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
RISANKIZUMAB-RZAA 75MG/0.83ML X2 SYR KIT |
| VA PRODUCT IDENTIFIER |
R0391 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4038360 |
| EFFECTIVE DATE/TIME |
-
- 2019-05-09 00:00:00
- STATUS: ACTIVE
|
