AVALGLUCOSIDASE ALFA-NGPT 100MG/VIAL INJ,LYPHL (31373)    VA PRODUCT (50.68)

Name Value
NAME AVALGLUCOSIDASE ALFA-NGPT 100MG/VIAL INJ,LYPHL
VA GENERIC NAME AVALGLUCOSIDASE ALFA-NGPT
DOSAGE FORM INJ,LYPHL
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 100
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/VIAL
NATIONAL FORMULARY NAME AVALGLUCOSIDASE ALFA-NGPT INJ,LYPHL
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:   2021-08-19 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME AVALGLUCOSIDASE ALFA-NGPT 100MG/VIAL INJ
VA PRODUCT IDENTIFIER A2104
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4040756
EFFECTIVE DATE/TIME
  • 2021-08-19 00:00:00
    STATUS:   ACTIVE
  • 2021-08-19 00:00:00
    STATUS:   ACTIVE