THEOPHYLLINE 100MG TAB,SA (QUALITEST) (3181)    VA PRODUCT (50.68)

Name Value
NAME THEOPHYLLINE 100MG TAB,SA (QUALITEST)
VA GENERIC NAME THEOPHYLLINE
DOSAGE FORM TAB,SA
ACTIVE INGREDIENTS
NATIONAL FORMULARY RESTRICTION 
Refer to VA/DoD COPD treatment guidelines
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 100
INACTIVATION DATE 2008-07-07 00:00:00
UNITS MG
DSS NUMBER 111
NATIONAL FORMULARY NAME THEOPHYLLINE TAB,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 (QUALITEST) 100MG SA TAB
VA PRODUCT IDENTIFIER T0311
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4003751
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2008-07-07 00:00:00
    STATUS:   INACTIVE