ARIPIPRAZOLE 400MG/SYR INJ,SUSP,SA,KIT (26009)    VA PRODUCT (50.68)

Name Value
NAME ARIPIPRAZOLE 400MG/SYR INJ,SUSP,SA,KIT
VA GENERIC NAME ARIPIPRAZOLE
DOSAGE FORM INJ,SUSP,SA
FDA MED GUIDE Aripiprazole_Inj_(Abilify_Maintena)_(2017).pdf
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 400
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG
NATIONAL FORMULARY NAME ARIPIPRAZOLE 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 YES
PGX SUPPRESSED NO
VA PRINT NAME ARIPIPRAZOLE 400MG/SYR SA INJ SUSP
VA PRODUCT IDENTIFIER A1832
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4034788
EFFECTIVE DATE/TIME
  • 2015-09-10 00:00:00
    STATUS:   ACTIVE