| NAME |
CLOBAZAM 2.5MG/ML SUSP,ORAL |
| VA GENERIC NAME |
CLOBAZAM |
| DOSAGE FORM |
SUSP,ORAL |
| FDA MED GUIDE |
Clobazam_Susp_(Generic)_(2022).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule IV |
| STRENGTH |
2.5 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/ML |
| NATIONAL FORMULARY NAME |
CLOBAZAM SUSP,ORAL |
| 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: 2018-10-31 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2018-11-01 00:00:00
|
| PGX ELIGIBLE |
YES |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
CLOBAZAM 2.5MG/ML ORAL SUSP |
| VA PRODUCT IDENTIFIER |
C1587 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4032616 |
| EFFECTIVE DATE/TIME |
-
- 2013-08-19 00:00:00
- STATUS: ACTIVE
|
