| NAME |
NALOXONE RESCUE KIT INTRAMUSCULAR |
| VA GENERIC NAME |
NALOXONE |
| DOSAGE FORM |
KIT |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
NALOXONE KIT |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
- COPAY END DATE: 2017-03-31 00:00:00
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2017-04-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
NALOXONE RESCUE KIT,IM |
| VA PRODUCT IDENTIFIER |
N0711 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4033094 |
| EFFECTIVE DATE/TIME |
-
- 2014-02-21 00:00:00
- STATUS: ACTIVE
|
