DICYCLOMINE HCL 10MG/5ML SYRUP (2000)    VA PRODUCT (50.68)

Name Value
NAME DICYCLOMINE HCL 10MG/5ML SYRUP
VA GENERIC NAME DICYCLOMINE
DOSAGE FORM SYRUP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 10
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2021-07-15 00:00:00
UNITS MG/5ML
DSS NUMBER 4
NATIONAL FORMULARY NAME DICYCLOMINE SYRUP
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 DICYCLOMINE HCL 10MG/5ML SYRUP
VA PRODUCT IDENTIFIER D0206
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4002584
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2021-07-15 00:00:00
    STATUS:   INACTIVE
  • 2021-07-15 00:00:00
    STATUS:   INACTIVE
  • 2021-07-15 00:00:00
    STATUS:   INACTIVE