LORAZEPAM 1MG CAP,SA (31422)    VA PRODUCT (50.68)

Name Value
NAME LORAZEPAM 1MG CAP,SA
VA GENERIC NAME LORAZEPAM
DOSAGE FORM CAP,SA
FDA MED GUIDE Lorazepam_SA_(Loreev-XR)_(2023).pdf
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Schedule IV
STRENGTH 1
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
NATIONAL FORMULARY NAME LORAZEPAM CAP,SA
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Both Inpatient and Outpatient
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2021-09-16 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME LORAZEPAM 1MG SA CAP
VA PRODUCT IDENTIFIER L0884
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4040808
EFFECTIVE DATE/TIME
  • 2021-09-16 00:00:00
    STATUS:   ACTIVE
  • 2021-09-16 00:00:00
    STATUS:   ACTIVE
  • 2021-09-16 00:00:00
    STATUS:   ACTIVE