| NAME |
FENTANYL CITRATE 400MCG TAB,BUCCAL |
| VA GENERIC NAME |
FENTANYL |
| DOSAGE FORM |
TAB,BUCCAL |
| FDA MED GUIDE |
Fentanyl_Buccal_Tab_(Generic)_(2021).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule II |
| STRENGTH |
400 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MCG |
| NATIONAL FORMULARY NAME |
FENTANYL TAB,BUCCAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
- COPAY END DATE: 2019-06-20 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2019-06-21 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
FENTANYL CITRATE 400MCG BUCCAL TAB |
| VA PRODUCT IDENTIFIER |
F0376 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
TAB |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4025733 |
| EFFECTIVE DATE/TIME |
-
- 2006-11-29 00:00:00
- STATUS: ACTIVE
|
