BELZUTIFAN 40MG TAB (31409)    VA PRODUCT (50.68)

Name Value
NAME BELZUTIFAN 40MG TAB
VA GENERIC NAME BELZUTIFAN
DOSAGE FORM TAB
FDA MED GUIDE Belzutifan_(Welireg)_(2021).pdf
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR TEXT
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 40
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME BELZUTIFAN TAB
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Both Inpatient and Outpatient
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2021-09-11 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME BELZUTIFAN 40MG TAB
VA PRODUCT IDENTIFIER B0923
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4040794
EFFECTIVE DATE/TIME
  • 2021-09-11 00:00:00
    STATUS:   ACTIVE
  • 2021-09-11 00:00:00
    STATUS:   ACTIVE