| NAME |
DIAZEPAM 5MG/SPRAY SOLN,SPRAY,NASAL,2 |
| VA GENERIC NAME |
DIAZEPAM |
| DOSAGE FORM |
SOLN,SPRAY,NASAL |
| FDA MED GUIDE |
Diazepam_Nasal_(Valtoco)_(2023).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR TEXT |
|
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule IV |
| STRENGTH |
5 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/SPRAY |
| NATIONAL FORMULARY NAME |
DIAZEPAM SOLN,SPRAY,NASAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2020-01-23 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DIAZEPAM 5MG/SPRAY NASAL SOLN 2 |
| VA PRODUCT IDENTIFIER |
D1233 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
PKG |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4039097 |
| EFFECTIVE DATE/TIME |
-
- 2020-01-23 00:00:00
- STATUS: ACTIVE
|
