| NAME |
MIDAZOLAM 5MG/SPRAY SOLN,SPRAY,NASAL |
| VA GENERIC NAME |
MIDAZOLAM |
| DOSAGE FORM |
SOLN,SPRAY,NASAL |
| FDA MED GUIDE |
Midazolam_(Nayzilam)_(2023).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR |
PA-F |
| FORMULARY DESIGNATOR TEXT |
Restricted to Neurology
|
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Schedule IV |
| STRENGTH |
5 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/SPRAY |
| NATIONAL FORMULARY NAME |
MIDAZOLAM SOLN,SPRAY,NASAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2019-09-19 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
MIDAZOLAM 5MG/SPRAY SOLN NASAL SPRAY |
| VA PRODUCT IDENTIFIER |
M1224 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4038707 |
| EFFECTIVE DATE/TIME |
-
- 2019-09-19 00:00:00
- STATUS: ACTIVE
|
