DIPHENHYDRAMINE 1%/TRIPELENNAMINE 0.5% SPRAY,TOP (10197) VA PRODUCT (50.68)

Name	Value
NAME	DIPHENHYDRAMINE 1%/TRIPELENNAMINE 0.5% SPRAY,TOP
VA GENERIC NAME	DIPHENHYDRAMINE/TRIPELENNAMINE
DOSAGE FORM	SPRAY,TOP
ACTIVE INGREDIENTS	DIPHENHYDRAMINE HYDROCHLORIDE STRENGTH: 1 UNITS: % BENZALKONIUM CHLORIDE STRENGTH: 0.12 UNITS: % TRIPELENNAMINE HYDROCHLORIDE STRENGTH: 0.5 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-28 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	DIPHENHYDRAMINE/TRIPELENNAMINE SOLN
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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4010572
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-28 00:00:00 STATUS: INACTIVE