PHENYLEPHRINE 5MG/PROMETHAZINE 6.25MG/5ML SYRUP (1864) VA PRODUCT (50.68)

Name	Value
NAME	PHENYLEPHRINE 5MG/PROMETHAZINE 6.25MG/5ML SYRUP
VA GENERIC NAME	PHENYLEPHRINE/PROMETHAZINE
DOSAGE FORM	SYRUP
ACTIVE INGREDIENTS	PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG/5ML PROMETHAZINE HYDROCHLORIDE STRENGTH: 6.25 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	1
NATIONAL FORMULARY NAME	PHENYLEPHRINE/PROMETHAZINE SYRUP
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	4002449
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE