KETOPROFEN 12.5MG CAP (2831)    VA PRODUCT (50.68)

Name Value
NAME KETOPROFEN 12.5MG CAP
VA GENERIC NAME KETOPROFEN
DOSAGE FORM CAP,ORAL
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT 
Transitioning service members, or
After trial of 2 formulary NSAIDs
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 12.5
INACTIVATION DATE 2002-12-06 00:00:00
UNITS MG
DSS NUMBER 8
NATIONAL FORMULARY NAME KETOPROFEN CAP,ORAL
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 KETOPROFEN 12.5MG CAP
VA PRODUCT IDENTIFIER K0028
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4003410
EFFECTIVE DATE/TIME
  • 2002-12-06 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE