| NAME |
BISACODYL 5MG TAB #4/PEG-3350/ELECTROLYTES KIT |
| VA GENERIC NAME |
BISACODYL/ELECTROLYTES/PEG-3350 |
| DOSAGE FORM |
KIT |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2010-09-02 00:00:00 |
| NATIONAL FORMULARY NAME |
BISACODYL/ELECTROLYTES/PEG-3350 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 |
HALFLYTELY BOWEL PREP KIT |
| VA PRODUCT IDENTIFIER |
B0564 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4025963 |
| EFFECTIVE DATE/TIME |
-
- 2007-04-25 00:00:00
- STATUS: ACTIVE
-
- 2010-09-02 00:00:00
- STATUS: INACTIVE
|
