BELLADONNA ALKALOIDS 0.3888MG/PHENOBARBITAL 48.6MG TAB,SA (4069) VA PRODUCT (50.68)

Name	Value
NAME	BELLADONNA ALKALOIDS 0.3888MG/PHENOBARBITAL 48.6MG TAB,SA
VA GENERIC NAME	ATROPINE/HYOSCYAMINE/PHENOBARBITAL/SCOPOLAMINE
DOSAGE FORM	TAB,SA
ACTIVE INGREDIENTS	ATROPINE SULFATE STRENGTH: 0.0582 UNITS: MG PHENOBARBITAL STRENGTH: 48.6 UNITS: MG HYOSCYAMINE SULFATE STRENGTH: 0.3111 UNITS: MG SCOPOLAMINE HYDROBROMIDE STRENGTH: 0.0195 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2016-01-26 00:00:00
DSS NUMBER	4
NATIONAL FORMULARY NAME	ATROPINE/HYOSCYAMINE/PHENOBARBITAL/SCOPOLAMINE 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	BELLADONNA ALK 0.38/PHENOBARB 50MG SA TB
VA PRODUCT IDENTIFIER	B0337
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4004622
EFFECTIVE DATE/TIME	2004-02-10 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE 2012-07-09 00:00:00 STATUS: ACTIVE