LISOCABTAGENE MARALEUCEL 50000000T CELLS/VIAL (30744)    VA PRODUCT (50.68)

Name Value
NAME LISOCABTAGENE MARALEUCEL 50000000T CELLS/VIAL
VA GENERIC NAME LISOCABTAGENE MARALEUCEL
DOSAGE FORM INJ,SUSP
FDA MED GUIDE Lisocabtagene-Maraleucel_(Breyanzi)_(2021).pdf
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 10000000
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS T CELLS/ML
NATIONAL FORMULARY NAME LISOCABTAGENE MARALEUCEL INJ,SUSP
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:   2021-02-22 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME LISOCABTAGENE MARALEU 50000000T CELLS/VI
VA PRODUCT IDENTIFIER L0872
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4040074
EFFECTIVE DATE/TIME
  • 2021-02-22 00:00:00
    STATUS:   ACTIVE
  • 2021-02-22 00:00:00
    STATUS:   ACTIVE
  • 2021-02-22 00:00:00
    STATUS:   ACTIVE