| NAME |
ROMIPLOSTIM 125MCG/VIL INJ |
| VA GENERIC NAME |
ROMIPLOSTIM |
| DOSAGE FORM |
INJ,LYPHL |
| FDA MED GUIDE |
Romiplostim_(Nplate)_(2021).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR |
PA-F |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
125 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MCG/VIL |
| NATIONAL FORMULARY NAME |
ROMIPLOSTIM INJ,LYPHL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2019-11-29 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ROMIPLOSTIM 125MCG/VIL INJ |
| VA PRODUCT IDENTIFIER |
R0403 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4038976 |
| EFFECTIVE DATE/TIME |
-
- 2019-12-02 00:00:00
- STATUS: ACTIVE
|
