| NAME |
DIPHENHYDRAMINE 25MG/PHENYLEPHRINE 10MG TAB,CHEW |
| VA GENERIC NAME |
DIPHENHYDRAMINE/PHENYLEPHRINE |
| DOSAGE FORM |
TAB,CHEWABLE |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2011-12-07 00:00:00 |
| NATIONAL FORMULARY NAME |
DIPHENHYDRAMINE/PHENYLEPHRINE TAB,CHEWABLE |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DP-HYDRAMINE 25/P-EPHRINE 10MG CHEW TAB |
| VA PRODUCT IDENTIFIER |
D0625 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
TAB |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4016945 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2011-12-07 00:00:00
- STATUS: INACTIVE
|
