COLESTIPOL GRANULES (2907)    VA PRODUCT (50.68)

Name Value
NAME COLESTIPOL GRANULES
VA GENERIC NAME COLESTIPOL
DOSAGE FORM GRNL,RCNST-ORAL
ACTIVE INGREDIENTS
NATIONAL FORMULARY RESTRICTION
Refer to VA/DoD Hyperlipidemia treatment guidelines
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
DSS NUMBER 2
NATIONAL FORMULARY NAME COLESTIPOL GRANULES
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 COLESTIPOL GRANULES
VA PRODUCT IDENTIFIER C0510
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4003486
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE