FACTOR IX,RECOMBINANT ALBUMIN FUSION 3500 UNIT/VIL INJ (32454)    VA PRODUCT (50.68)

Name Value
NAME FACTOR IX,RECOMBINANT ALBUMIN FUSION 3500 UNIT/VIL INJ
VA GENERIC NAME FACTOR IX,RECOMBINANT
DOSAGE FORM INJ
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 3500
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS UNT/VIL
NATIONAL FORMULARY NAME FACTOR IX,RECOMBINANT INJ
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2023-01-19 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME FACTOR IX,REC ALBUM FUSION 3500 UNIT/VIL
VA PRODUCT IDENTIFIER F0745
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4041969
EFFECTIVE DATE/TIME
  • 2023-01-19 00:00:00
    STATUS:   ACTIVE