FOSINOPRIL NA 10MG TAB,UD (13575)    VA PRODUCT (50.68)

Name Value
NAME FOSINOPRIL NA 10MG TAB,UD
VA GENERIC NAME FOSINOPRIL
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 10
INACTIVATION DATE 2008-08-14 00:00:00
UNITS MG
NATIONAL FORMULARY NAME FOSINOPRIL TAB
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   1
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
    COPAY END DATE:   2017-12-31 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2018-01-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME FOSINOPRIL NA 10MG TAB UD
VA PRODUCT IDENTIFIER F0223
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4013940
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-19 00:00:00
    STATUS:   INACTIVE
  • 2007-10-10 00:00:00
    STATUS:   ACTIVE
  • 2008-08-14 00:00:00
    STATUS:   INACTIVE