CAPTOPRIL 12.5MG TAB,UD (13551)    VA PRODUCT (50.68)

Name Value
NAME CAPTOPRIL 12.5MG TAB,UD
VA GENERIC NAME CAPTOPRIL
DOSAGE FORM TAB
ACTIVE INGREDIENTS
NATIONAL FORMULARY RESTRICTION
Refer to PBM/MAP Hypertension treatment and CHF treatment guidelines and 
PBM/TAG Diabetes treatment guidelines
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 12.5
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
NATIONAL FORMULARY NAME CAPTOPRIL TAB
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME CAPTOPRIL 12.5MG TAB UD
VA PRODUCT IDENTIFIER C0913
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4013916
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE