| NAME |
FINGOLIMOD 0.25MG TAB,ORAL DISINTEGRATING |
| VA GENERIC NAME |
FINGOLIMOD |
| DOSAGE FORM |
TAB,ORAL DISINTEGRATING |
| FDA MED GUIDE |
Fingolimod_ODT_(Tascenso ODT)_(2021).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
0.25 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| INACTIVATION DATE |
2023-01-17 00:00:00 |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
FINGOLIMOD TAB,ORAL DISINTEGRATING |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
1x Possible Dosage |
| PACKAGE |
Both Inpatient and Outpatient |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2022-08-04 00:00:00
- COPAY END DATE: 2022-11-23 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2022-11-24 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
FINGOLIMOD 0.25MG ODT |
| VA PRODUCT IDENTIFIER |
F0733 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
TAB |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4041628 |
| EFFECTIVE DATE/TIME |
-
- 2022-08-04 00:00:00
- STATUS: ACTIVE
-
- 2023-01-17 00:00:00
- STATUS: INACTIVE
|
