| NAME |
BUPRENORPHINE 100MG/0.5ML INJ,SA,SYRINGE,0.5ML |
| VA GENERIC NAME |
BUPRENORPHINE |
| DOSAGE FORM |
INJ,SOLN,SA |
| FDA MED GUIDE |
Buprenorphine_SA_Inj_(Sublocade)_(2021).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR |
PA-F |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Schedule III |
| STRENGTH |
100 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/0.5ML |
| NATIONAL FORMULARY NAME |
BUPRENORPHINE INJ,SOLN,SA |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2018-02-01 00:00:00
- COPAY END DATE: 2021-05-23 00:00:00
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2021-05-24 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
BUPRENORPHINE 100MG/0.5ML SA INJ SYR |
| VA PRODUCT IDENTIFIER |
B0852 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
SYR |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037190 |
| EFFECTIVE DATE/TIME |
-
- 2017-12-28 00:00:00
- STATUS: ACTIVE
|
