SCOPOLAMINE 0.5MG/72HRS PATCH (4984)    VA PRODUCT (50.68)

Name Value
NAME SCOPOLAMINE 0.5MG/72HRS PATCH
VA GENERIC NAME SCOPOLAMINE
DOSAGE FORM PATCH
FORMULARY DESIGNATOR TEXT 
Dispensing limited to 4 patches with no refills for indication of post-op N/V.. These quantity limitations do not apply to other indications
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 0.5
INACTIVATION DATE 1998-11-16 00:00:00
UNITS MG/72HRS
DSS NUMBER 3
NATIONAL FORMULARY NAME SCOPOLAMINE PATCH
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 SCOPOLAMINE 0.5MG/72HR PATCH
VA PRODUCT IDENTIFIER S0481
TRANSMIT TO CMOP NO
VA DISPENSE UNIT PATCH
MASTER ENTRY FOR VUID YES
VUID 4005525
EFFECTIVE DATE/TIME
  • 1998-11-16 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE