PALIPERIDONE PALMITATE 156MG/KIT INJ,SUSP,SA (21022)    VA PRODUCT (50.68)

Name Value
NAME PALIPERIDONE PALMITATE 156MG/KIT INJ,SUSP,SA
VA GENERIC NAME PALIPERIDONE
DOSAGE FORM INJ,SUSP,SA
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 156
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME PALIPERIDONE INJ,SUSP,SA
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME PALIPERIDONE PALM 156MG/KIT SA INJ SUSP
VA PRODUCT IDENTIFIER P0924
TRANSMIT TO CMOP YES
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4029124
EFFECTIVE DATE/TIME
  • 2009-10-01 00:00:00
    STATUS:   ACTIVE