| NAME |
PEGCETACOPLAN 15MG/0.1ML INJ,OPH |
| VA GENERIC NAME |
PEGCETACOPLAN |
| DOSAGE FORM |
INJ,SOLN |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR TEXT |
Restricted to ophthalmology/retinal specialists
|
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
15 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/0.1ML |
| NATIONAL FORMULARY NAME |
PEGCETACOPLAN INJ,SOLN |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2023-03-02 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
PEGCETACOPLAN 15MG/0.1ML OPH INJ |
| VA PRODUCT IDENTIFIER |
P1321 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042070 |
| EFFECTIVE DATE/TIME |
-
- 2023-03-02 00:00:00
- STATUS: ACTIVE
|
