GLYBURIDE 5MG TAB,UD (13581)    VA PRODUCT (50.68)

Name Value
NAME GLYBURIDE 5MG TAB,UD
VA GENERIC NAME GLYBURIDE
DOSAGE FORM TAB
ACTIVE INGREDIENTS
NATIONAL FORMULARY RESTRICTION 
Refer to PBM/MAP and PBM/TAG Diabetes treatment guidelines
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 5
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2021-03-15 00:00:00
UNITS MG
NATIONAL FORMULARY NAME GLYBURIDE 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 GLYBURIDE 5MG TAB UD
VA PRODUCT IDENTIFIER G0186
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4013946
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2021-03-15 00:00:00
    STATUS:   INACTIVE
  • 2021-03-15 00:00:00
    STATUS:   INACTIVE
  • 2021-03-15 00:00:00
    STATUS:   INACTIVE