ALGLUCOSIDASE ALFA (MYOZYME) 50MG/VIL INJ (21963)    VA PRODUCT (50.68)

Name Value
NAME ALGLUCOSIDASE ALFA (MYOZYME) 50MG/VIL INJ
VA GENERIC NAME ALGLUCOSIDASE
DOSAGE FORM INJ,LYPHL
ACTIVE INGREDIENTS
  1. ACTIVE INGREDIENTS:   ALGLUCOSIDASE ALFA
    STRENGTH:   50
    UNITS:   MG/VIAL
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 50
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2016-12-27 00:00:00
UNITS MG/VIAL
NATIONAL FORMULARY NAME ALGLUCOSIDASE INJ,LYPHL
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  1. CODING SYSTEM:   RxNorm
    CODE:
COPAY TIER
  1. COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
VA PRINT NAME ALGLUCOSIDASE ALPHA MYOZYME 50MG/VIL INJ
VA PRODUCT IDENTIFIER A1572
TRANSMIT TO CMOP YES
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4030176
EFFECTIVE DATE/TIME
  1. EFFECTIVE DATE/TIME:   2010-10-13 00:00:00
    STATUS:   ACTIVE