UROGESIC-BLUE TAB (9940) VA PRODUCT (50.68)

Name	Value
NAME	UROGESIC-BLUE TAB
VA GENERIC NAME	HYOSCYAMINE/METHENAMINE/METHYLENE BLUE/PHENYL SALICYLATE/SODIUM
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	METHENAMINE STRENGTH: 81.60 UNITS: MG METHYLENE BLUE STRENGTH: 10.80 UNITS: MG PHENYL SALICYLATE STRENGTH: 36 UNITS: MG SODIUM BIPHOSPHATE STRENGTH: 40.80 UNITS: MG HYOSCYAMINE STRENGTH: 0.12 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	1
NATIONAL FORMULARY NAME	HYOSCYAMINE/METHENAMINE/METHYLENE BLUE/PHENYL SALICYLATE/SODIUM 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	UROGESIC-BLUE TAB
VA PRODUCT IDENTIFIER	U0065
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4010333
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE