ZOLPIDEM TARTRATE 12.5MG TAB,SA,UD (17435)    VA PRODUCT (50.68)

Name Value
NAME ZOLPIDEM TARTRATE 12.5MG TAB,SA,UD
VA GENERIC NAME ZOLPIDEM
DOSAGE FORM TAB,SA
FDA MED GUIDE Zolpidem_SA_(Generic)_(2019).pdf
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Schedule IV
STRENGTH 12.5
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2019-09-16 00:00:00
UNITS MG
NATIONAL FORMULARY NAME ZOLPIDEM TAB,SA
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Inpatient
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 ZOLPIDEM TARTRATE 12.5MG SA TAB UD
VA PRODUCT IDENTIFIER Z0068
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4024867
EFFECTIVE DATE/TIME
  • 2006-01-24 00:00:00
    STATUS:   ACTIVE
  • 2019-09-16 00:00:00
    STATUS:   INACTIVE
  • 2019-09-16 00:00:00
    STATUS:   INACTIVE
  • 2019-09-16 00:00:00
    STATUS:   INACTIVE