| NAME |
BUPRENORPHINE 74.2 MG X 4/KIT IMPLANT |
| VA GENERIC NAME |
BUPRENORPHINE |
| DOSAGE FORM |
IMPLANT |
| FDA MED GUIDE |
Buprenorphine_Implant_(Probuphine)_(2021).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule III |
| STRENGTH |
74.2 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| INACTIVATION DATE |
2022-11-15 00:00:00 |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
BUPRENORPHINE IMPLANT |
| 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: 2022-08-10 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2022-08-11 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
BUPRENORPHINE 74.2 MG X 4/KIT IMPLANT |
| VA PRODUCT IDENTIFIER |
B0825 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035796 |
| EFFECTIVE DATE/TIME |
-
- 2016-06-10 00:00:00
- STATUS: ACTIVE
-
- 2022-11-15 00:00:00
- STATUS: INACTIVE
|
