CYCLOPENTOLATE HCL 1%/PHENYLEPHRINE HCL 10% SOLN,OPH (4992)    VA PRODUCT (50.68)

Name Value
NAME CYCLOPENTOLATE HCL 1%/PHENYLEPHRINE HCL 10% SOLN,OPH
VA GENERIC NAME CYCLOPENTOLATE/PHENYLEPHRINE
DOSAGE FORM SOLN,OPH
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2003-08-01 00:00:00
DSS NUMBER 2
NATIONAL FORMULARY NAME CYCLOPENTOLATE/PHENYLEPHRINE SOLN,OPH
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 CYCLOPENTOLATE 1/PHENYLEPH 10% OPH SOLN
VA PRODUCT IDENTIFIER C0329
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4005533
EFFECTIVE DATE/TIME
  • 2003-08-01 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE