APOMORPHINE HCL FILM,SUBLINGUAL TITRATION KIT,10 (30211)    VA PRODUCT (50.68)

Name Value
NAME APOMORPHINE HCL FILM,SUBLINGUAL TITRATION KIT,10
VA GENERIC NAME APOMORPHINE
DOSAGE FORM FILM,SUBLINGUAL
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT 
Restricted to Neurology
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME APOMORPHINE FILM,SUBLINGUAL
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2020-06-18 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME APOMORPHINE HCL SL FILM TITRATION KIT,10
VA PRODUCT IDENTIFIER A2064
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4039471
EFFECTIVE DATE/TIME
  • 2020-06-18 00:00:00
    STATUS:   ACTIVE