DARATUMUMAB 120MG/HYALURONIDASE-FIHJ 2000UNIT/ML INJ SOLN (30128)    VA PRODUCT (50.68)

Name Value
NAME DARATUMUMAB 120MG/HYALURONIDASE-FIHJ 2000UNIT/ML INJ SOLN
VA GENERIC NAME DARATUMUMAB/HYALURONIDASE-FIHJ
DOSAGE FORM INJ,SOLN
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 DARATUMUMAB/HYALURONIDASE-FIHJ INJ,SOLN
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:   2020-05-15 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DARZALEX FASPRO 120MG/2000UNIT/ML INJ
VA PRODUCT IDENTIFIER D1240
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4039375
EFFECTIVE DATE/TIME
  • 2020-05-15 00:00:00
    STATUS:   ACTIVE
  • 2020-05-15 00:00:00
    STATUS:   ACTIVE