THEOPHYLLINE 65MG CAP,SA (3113)    VA PRODUCT (50.68)

Name Value
NAME THEOPHYLLINE 65MG CAP,SA
VA GENERIC NAME THEOPHYLLINE
DOSAGE FORM CAP,SA
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 65
INACTIVATION DATE 2003-08-01 00:00:00
UNITS MG
DSS NUMBER 42
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 65MG SA CAP
VA PRODUCT IDENTIFIER T0166
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4003687
EFFECTIVE DATE/TIME
  • 2003-08-01 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE