| NAME |
FENTANYL 400MCG/SPRAY SOLN,NASAL |
| VA GENERIC NAME |
FENTANYL |
| DOSAGE FORM |
SOLN,SPRAY,NASAL |
| FDA MED GUIDE |
Fentanyl_Nasal_(Lazanda)_(2021).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule II |
| STRENGTH |
400 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MCG/SPRAY |
| NATIONAL FORMULARY NAME |
FENTANYL SOLN,SPRAY,NASAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
- COPAY END DATE: 2023-02-15 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2023-02-16 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
FENTANYL 400MCG/SPRAY NASAL SOLN |
| VA PRODUCT IDENTIFIER |
F0506 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
BTL |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4030941 |
| EFFECTIVE DATE/TIME |
-
- 2011-09-12 00:00:00
- STATUS: ACTIVE
|
