DIETHYLSTILBESTROL 0.25MG/METHYLTESTOSTERONE 5MG TAB (178)    VA PRODUCT (50.68)

Name Value
NAME DIETHYLSTILBESTROL 0.25MG/METHYLTESTOSTERONE 5MG TAB
VA GENERIC NAME DIETHYLSTILBESTROL/METHYLTESTOSTERONE
DOSAGE FORM TAB
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Schedule IV
INACTIVATION DATE 2002-05-24 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME DIETHYLSTILBESTROL/METHYLTESTOSTERONE TAB
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
TRANSMIT TO CMOP NO
MASTER ENTRY FOR VUID YES
VUID 4000801
EFFECTIVE DATE/TIME
  • 2002-05-24 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE