NIFEDIPINE (PROCARDIA XL) 30MG SA TAB (4032)    VA PRODUCT (50.68)

Name Value
NAME NIFEDIPINE (PROCARDIA XL) 30MG SA TAB
VA GENERIC NAME NIFEDIPINE
DOSAGE FORM TAB,SA
ACTIVE INGREDIENTS
NATIONAL FORMULARY RESTRICTION 
Refer to PBM/MAP criteria for use of long-acting dihydropyridine calcium 
antagonists
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 30
INACTIVATION DATE 2006-11-14 00:00:00
UNITS MG
DSS NUMBER 3
NATIONAL FORMULARY NAME NIFEDIPINE TAB,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 NIFEDIPINE (PROCARDIA XL) 30MG SA TAB
VA PRODUCT IDENTIFIER N0043
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4004585
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2006-11-14 00:00:00
    STATUS:   INACTIVE
  • 2006-11-14 00:00:00
    STATUS:   INACTIVE