VERAPAMIL HCL 120MG CAP,SA (3063)    VA PRODUCT (50.68)

Name Value
NAME VERAPAMIL HCL 120MG CAP,SA
VA GENERIC NAME VERAPAMIL
DOSAGE FORM CAP,SA
ACTIVE INGREDIENTS
NATIONAL FORMULARY RESTRICTION
Refer to PBM/MAP Hypertension treatment and CHF treatment guidelines
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 120
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
DSS NUMBER 7
NATIONAL FORMULARY NAME VERAPAMIL CAP,SA
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 VERAPAMIL HCL 120MG SA CAP
VA PRODUCT IDENTIFIER V0005
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4003638
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE