VERAPAMIL HCL 120MG TAB,SA (3067)    VA PRODUCT (50.68)

Name Value
NAME VERAPAMIL HCL 120MG TAB,SA
VA GENERIC NAME VERAPAMIL
DOSAGE FORM TAB
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
INACTIVATION DATE 2000-08-18 00:00:00
UNITS MG
DSS NUMBER 12
NATIONAL FORMULARY NAME VERAPAMIL TAB
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   1
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
    COPAY END DATE:   2020-12-31 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2021-01-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME VERAPAMIL HCL 120MG SA TAB
VA PRODUCT IDENTIFIER V0054
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID NO
VUID 4003642
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2005-12-08 00:00:00
    STATUS:   ACTIVE
  • 2000-08-18 00:00:00
    STATUS:   INACTIVE