THEOPHYLLINE,ANHYDROUS 125MG SPRINKLE CAP,SA (3116) VA PRODUCT (50.68)

Name	Value
NAME	THEOPHYLLINE,ANHYDROUS 125MG SPRINKLE CAP,SA
VA GENERIC NAME	THEOPHYLLINE
DOSAGE FORM	CAP,SPRINKLE,SA
ACTIVE INGREDIENTS	THEOPHYLLINE STRENGTH: 125 UNITS: MG THEOPHYLLINE,ANHYDROUS STRENGTH: 125 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
STRENGTH	125
INACTIVATION DATE	2004-11-19 00:00:00
UNITS	MG
DSS NUMBER	62
NATIONAL FORMULARY NAME	THEOPHYLLINE CAP,SPRINKLE,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 SPRINKLE SA CAP
VA PRODUCT IDENTIFIER	T0150
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	NO
VUID	4003690
EFFECTIVE DATE/TIME	2004-11-19 00:00:00 STATUS: INACTIVE 2005-12-06 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE