THEOPHYLLINE 125MG CAP,SA (3104)    VA PRODUCT (50.68)

Name Value
NAME THEOPHYLLINE 125MG CAP,SA
VA GENERIC NAME THEOPHYLLINE
DOSAGE FORM CAP,SA
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 125
INACTIVATION DATE 2009-06-12 00:00:00
UNITS MG
DSS NUMBER 33
NATIONAL FORMULARY NAME THEOPHYLLINE CAP,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 125MG SA CAP
VA PRODUCT IDENTIFIER T0149
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4003678
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
  • 2009-06-12 00:00:00
    STATUS:   INACTIVE