| NAME |
CLONIDINE 0.1MG/24HRS PATCH |
| VA GENERIC NAME |
CLONIDINE |
| DOSAGE FORM |
PATCH |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY RESTRICTION |
Refer to PBM/MAP Hypertension treatment guidelines
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
0.1 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
MG/24HRS |
| DSS NUMBER |
5 |
| NATIONAL FORMULARY NAME |
CLONIDINE PATCH |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
CLONIDINE 0.1MG/24HR PATCH |
| VA PRODUCT IDENTIFIER |
C1258 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
PATCH |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4002473 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
|
