BISACODYL 1.5MG/TANNIC ACID 2.5GM ENEMA (4563) VA PRODUCT (50.68)

Name	Value
NAME	BISACODYL 1.5MG/TANNIC ACID 2.5GM ENEMA
VA GENERIC NAME	BISACODYL/TANNIC ACID
DOSAGE FORM	ENEMA
ACTIVE INGREDIENTS	BISACODYL STRENGTH: 1.5 UNITS: MG TANNIC ACID STRENGTH: 2.5 UNITS: GM
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	BISACODYL/TANNIC ACID ENEMA
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	BISACODYL 1.5MG/TANNIC ACID 2.5GM ENEMA
VA PRODUCT IDENTIFIER	B0184
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4005110
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE