THEOPHYLLINE 250MG CAP,SA (SLO-PHYLLIN GYROCAPS) (3147)    VA PRODUCT (50.68)

Name Value
NAME THEOPHYLLINE 250MG CAP,SA (SLO-PHYLLIN GYROCAPS)
VA GENERIC NAME THEOPHYLLINE
DOSAGE FORM CAP,SA
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 250
INACTIVATION DATE 2003-04-16 00:00:00
UNITS MG
DSS NUMBER 77
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 (SLO-PHYLLIN) 250MG SA CAP
VA PRODUCT IDENTIFIER T0272
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4003717
EFFECTIVE DATE/TIME
  • 2003-04-16 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE