CHLORPHENIRAMINE 4MG/IBUPROFEN 200MG/PHENYLEPHRINE 10MG TAB (31667) VA PRODUCT (50.68)

Name	Value
NAME	CHLORPHENIRAMINE 4MG/IBUPROFEN 200MG/PHENYLEPHRINE 10MG TAB
VA GENERIC NAME	CHLORPHENIRAMINE/IBUPROFEN/PHENYLEPHRINE
DOSAGE FORM	TAB
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	IBUPROFEN STRENGTH: 200 UNITS: MG PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 10 UNITS: MG CHLORPHENIRAMINE MALEATE STRENGTH: 4 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/IBUPROFEN/PHENYLEPHRINE TAB
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2022-01-10 00:00:00
PGX ELIGIBLE	YES
PGX SUPPRESSED	NO
VA PRINT NAME	CTM 4/IBUPRO 200/PHENYEPHRINE 10MG TAB
VA PRODUCT IDENTIFIER	C2019
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4041087
EFFECTIVE DATE/TIME	2022-01-10 00:00:00 STATUS: ACTIVE