FLUPHENAZINE DECANOATE 25MG/ML INJ (1290)    VA PRODUCT (50.68)

Name Value
NAME FLUPHENAZINE DECANOATE 25MG/ML INJ
VA GENERIC NAME FLUPHENAZINE
DOSAGE FORM INJ
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 25
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/ML
DSS NUMBER 1
NATIONAL FORMULARY NAME FLUPHENAZINE INJ
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME FLUPHENAZINE DECANOATE 25MG/ML INJ
VA PRODUCT IDENTIFIER F0053
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4001891
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE