USTELL CAP,ORAL (23798) VA PRODUCT (50.68)

Name	Value
NAME	USTELL CAP,ORAL
VA GENERIC NAME	HYOSCYAMINE/METHENAMINE/METHYLENE BLUE/PHENYL SALICYLATE/SODIUM
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	METHENAMINE STRENGTH: 120 UNITS: MG METHYLENE BLUE STRENGTH: 10 UNITS: MG PHENYL SALICYLATE STRENGTH: 36 UNITS: MG SODIUM PHOSPHATE MONOBASIC,MONOHYDRATE STRENGTH: 40.8 UNITS: MG HYOSCYAMINE STRENGTH: 0.12 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	HYOSCYAMINE/METHENAMINE/METHYLENE BLUE/PHENYL SALICYLATE/SODIUM CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	No Possible Dosages
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	USTELL ORAL CAP
VA PRODUCT IDENTIFIER	U0066
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4032295
EFFECTIVE DATE/TIME	2013-04-15 00:00:00 STATUS: ACTIVE