COLESTIPOL HCL GRANULES,FLAVORED (2909)    VA PRODUCT (50.68)

Name Value
NAME COLESTIPOL HCL GRANULES,FLAVORED
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 4
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 HCL GRANULES,FLAVORED
VA PRODUCT IDENTIFIER C0600
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4003488
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE