PALIPERIDONE PALMITATE 546MG/KIT (3 MONTH) INJ,SUSP,SA (25783)    VA PRODUCT (50.68)

Name Value
NAME PALIPERIDONE PALMITATE 546MG/KIT (3 MONTH) 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 546
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 546MG/KIT (3 MONTH) SA INJ
VA PRODUCT IDENTIFIER P1140
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4034534
EFFECTIVE DATE/TIME
  • 2015-06-23 00:00:00
    STATUS:   ACTIVE