| NAME |
BISACODYL 10MG SUPP/BISACODYL 5MG TAB #3/MG CIT 300ML |
| VA GENERIC NAME |
BISACODYL/MAGNESIUM CITRATE |
| DOSAGE FORM |
KIT |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY NAME |
BISACODYL/MAGNESIUM CITRATE KIT |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
EVAC-Q-KWIK KIT |
| VA PRODUCT IDENTIFIER |
B0187 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4016062 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
|
