THEOPHYLLINE 80MG/15ML ELIXIR (3084)    VA PRODUCT (50.68)

Name Value
NAME THEOPHYLLINE 80MG/15ML ELIXIR
VA GENERIC NAME THEOPHYLLINE
DOSAGE FORM ELIXIR
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 80
INACTIVATION DATE 2009-05-20 00:00:00
UNITS MG/15ML
DSS NUMBER 13
NATIONAL FORMULARY NAME THEOPHYLLINE ELIXIR
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 80MG/15ML ELIXIR
VA PRODUCT IDENTIFIER T0027
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4003658
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-27 00:00:00
    STATUS:   INACTIVE
  • 2007-10-10 00:00:00
    STATUS:   ACTIVE
  • 2009-05-20 00:00:00
    STATUS:   INACTIVE