DICYCLOMINE HCL 20MG/PHENOBARBITAL 15MG TAB (6572) VA PRODUCT (50.68)

Name	Value
NAME	DICYCLOMINE HCL 20MG/PHENOBARBITAL 15MG TAB
VA GENERIC NAME	DICYCLOMINE/PHENOBARBITAL
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	PHENOBARBITAL STRENGTH: 15 UNITS: MG DICYCLOMINE HYDROCHLORIDE STRENGTH: 20 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2002-04-04 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	DICYCLOMINE/PHENOBARBITAL TAB
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 20/PHENOBARBITAL 15MG TAB
VA PRODUCT IDENTIFIER	D0471
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4007088
EFFECTIVE DATE/TIME	2002-04-04 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE