DICYCLOMINE HCL 10MG/PHENOBARBITAL 15MG CAP (6571) VA PRODUCT (50.68)

Name	Value
NAME	DICYCLOMINE HCL 10MG/PHENOBARBITAL 15MG CAP
VA GENERIC NAME	DICYCLOMINE/PHENOBARBITAL
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	PHENOBARBITAL STRENGTH: 15 UNITS: MG DICYCLOMINE HYDROCHLORIDE STRENGTH: 10 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2002-04-04 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	DICYCLOMINE/PHENOBARBITAL CAP,ORAL
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	DICYCLOMINE 10/PHENOBARBITAL 15MG CAP
VA PRODUCT IDENTIFIER	D0470
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4007087
EFFECTIVE DATE/TIME	2002-04-04 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE