DICHLORPHENAMIDE 50MG TAB (2259)    VA PRODUCT (50.68)

Name Value
NAME DICHLORPHENAMIDE 50MG TAB
VA GENERIC NAME DICHLORPHENAMIDE
DOSAGE FORM TAB
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 50
UNITS MG
DSS NUMBER 1
NATIONAL FORMULARY NAME DICHLORPHENAMIDE 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
    COPAY END DATE:   2023-02-08 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2023-02-09 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DICHLORPHENAMIDE 50MG TAB
VA PRODUCT IDENTIFIER D0201
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4002842
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-19 00:00:00
    STATUS:   INACTIVE