ARIPIPRAZOLE 20MG TAB W/SENSOR,PATCH,KIT (28923)    VA PRODUCT (50.68)

Name Value
NAME ARIPIPRAZOLE 20MG TAB W/SENSOR,PATCH,KIT
VA GENERIC NAME ARIPIPRAZOLE
DOSAGE FORM TAB
FDA MED GUIDE Aripiprazole_(Abilify_Mycite)_(2020).pdf
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 20
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2022-09-15 00:00:00
UNITS MG
NATIONAL FORMULARY NAME ARIPIPRAZOLE TAB
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2018-11-26 00:00:00
    COPAY END DATE:   2022-06-15 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2022-06-16 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME ARIPIPRAZOLE 20MG TAB W/SENSOR,PATCH,KIT
VA PRODUCT IDENTIFIER A1998
TRANSMIT TO CMOP YES
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4038014
EFFECTIVE DATE/TIME
  • 2018-11-26 00:00:00
    STATUS:   ACTIVE
  • 2022-09-15 00:00:00
    STATUS:   INACTIVE