| NAME |
ARIPIPRAZOLE 400MG/VIL 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 |
|
| 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/VIL SA INJ SUSP |
| VA PRODUCT IDENTIFIER |
A1833 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4034789 |
| EFFECTIVE DATE/TIME |
-
- 2015-09-10 00:00:00
- STATUS: ACTIVE
|
