IDECABTAGENE VICLEUCEL INJ,SUSP (30991)    VA PRODUCT (50.68)

Name Value
NAME IDECABTAGENE VICLEUCEL INJ,SUSP
VA GENERIC NAME IDECABTAGENE VICLEUCEL
DOSAGE FORM INJ,SUSP
FDA MED GUIDE Idecabtagene_Vicleucel_(Abecma)_(2021).pdf
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME IDECABTAGENE VICLEUCEL 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:   2021-04-08 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME IDECABTAGENE VICLEUCEL INJ,SUSP
VA PRODUCT IDENTIFIER I0700
TRANSMIT TO CMOP NO
VA DISPENSE UNIT BAG
MASTER ENTRY FOR VUID YES
VUID 4040334
EFFECTIVE DATE/TIME
  • 2021-04-08 00:00:00
    STATUS:   ACTIVE
  • 2021-04-08 00:00:00
    STATUS:   ACTIVE
  • 2021-04-08 00:00:00
    STATUS:   ACTIVE