URINARY ANTISEPTIC W/METHENAMINE 81.6MG TAB (22510) VA PRODUCT (50.68)

Name	Value
NAME	URINARY ANTISEPTIC W/METHENAMINE 81.6MG TAB
VA GENERIC NAME	METHENAMINE/NA BIPHOSPHA/PHENYL SALICYLATE/METHELENE/HYOSCYAMINE
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	METHENAMINE STRENGTH: 81.6 UNITS: MG METHYLENE BLUE STRENGTH: 10.8 UNITS: MG PHENYL SALICYLATE STRENGTH: 36.2 UNITS: MG SODIUM BIPHOSPHATE STRENGTH: 40.8 UNITS: MG HYOSCYAMINE SULFATE STRENGTH: 0.12 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	METHENAMINE/NA BIPHOSPHA/PHENYL SALICYLATE/METHELENE/HYOSCYAMINE TAB
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	URINARY ANTISEP W/METHENAMINE 81.6MG TAB
VA PRODUCT IDENTIFIER	U0062
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4030803
EFFECTIVE DATE/TIME	2011-07-12 00:00:00 STATUS: ACTIVE