PHENYLEPHRINE TANNATE 5MG/PYRILAMINE TANNATE 30MG/5ML SUSP,ORAL (17479) VA PRODUCT (50.68)

Name	Value
NAME	PHENYLEPHRINE TANNATE 5MG/PYRILAMINE TANNATE 30MG/5ML SUSP,ORAL
VA GENERIC NAME	PHENYLEPHRINE/PYRILAMINE
DOSAGE FORM	SUSP,ORAL
ACTIVE INGREDIENTS	PHENYLEPHRINE TANNATE STRENGTH: 5 UNITS: MG/5ML PYRILAMINE TANNATE STRENGTH: 30 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2018-03-27 00:00:00
NATIONAL FORMULARY NAME	PHENYLEPHRINE/PYRILAMINE SUSP,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	P-EPHRINE 5/PYRILAMINE 30MG/5ML SUSP
VA PRODUCT IDENTIFIER	P0748
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4024980
EFFECTIVE DATE/TIME	2006-03-28 00:00:00 STATUS: ACTIVE 2018-03-27 00:00:00 STATUS: INACTIVE