LENVATINIB 4MG X 10 (8MG) DAILY PKT (30079)    VA PRODUCT (50.68)

Name Value
NAME LENVATINIB 4MG X 10 (8MG) DAILY PKT
VA GENERIC NAME LENVATINIB
DOSAGE FORM CAP,ORAL
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME LENVATINIB CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2020-04-23 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME LENVATINIB 4MG X 10 (8MG) DAILY PKT
VA PRODUCT IDENTIFIER L0848
TRANSMIT TO CMOP YES
VA DISPENSE UNIT PKT
MASTER ENTRY FOR VUID YES
VUID 4039318
EFFECTIVE DATE/TIME
  • 2020-04-23 00:00:00
    STATUS:   ACTIVE