THEOPHYLLINE 400MG TAB,SA (3079)    VA PRODUCT (50.68)

Name Value
NAME THEOPHYLLINE 400MG TAB,SA
VA GENERIC NAME THEOPHYLLINE
DOSAGE FORM TAB,SA
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 400
INACTIVATION DATE 2008-07-07 00:00:00
UNITS MG
DSS NUMBER 8
NATIONAL FORMULARY NAME THEOPHYLLINE TAB,SA
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 THEOPHYLLINE 400MG SA TAB
VA PRODUCT IDENTIFIER T0025
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4003653
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2008-07-07 00:00:00
    STATUS:   INACTIVE