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ONABOTULINUMTOXINA INJ,PWDR

Possible Synonyms: BOTOX, BOTOX COSMETIC

Drug Detail

Drug Class: MUSCULOSKELETAL AGENTS,OTHER

VA Class Code: MS900

Therapeutic Category: MUSCULOSKELETAL MEDICATIONS

Formulary Information

Formulary Status: PA-F Local Prior Authorization Required

Copay Tier: 3
Copay Tier Information on VA.gov

Urgent/Emergent Formulary: N

Additional Info

This product is on the VA national formulary and may have prior authorization requirements that are managed at the local facility level. Review the CFU documents below for requirements or contact your local VA pharmacy for additional instruction on obtaining a prior authorization for this medication.

At least one of the agents must be marked formulary, discretion is left to VISN or Facility to determine which agent(s).

Documents & Links

Trade Name Synonyms are listed within this application for reference only and do not imply brand name product coverage. VA Formulary coverage is for the generic product when one exists unless explicitly stated.
Last Formulary Data Refresh: 03/17/2025

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