| NAME |
ALPELISIB 200MGX28 (200MG) PKT |
| VA GENERIC NAME |
ALPELISIB |
| DOSAGE FORM |
TAB,ORAL |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
200 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
ALPELISIB TAB,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2019-06-06 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ALPELISIB 200MG X 28 (200MG) PKT |
| VA PRODUCT IDENTIFIER |
A2034 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4038451 |
| EFFECTIVE DATE/TIME |
-
- 2019-06-07 00:00:00
- STATUS: ACTIVE
|
