CTM 0.5MG/P-EPHRINE 1.25MG/P-PROPANOL 5MG/P-TOLOXAMINE 2MG/5ML (3260) VA PRODUCT (50.68)

Name	Value
NAME	CTM 0.5MG/P-EPHRINE 1.25MG/P-PROPANOL 5MG/P-TOLOXAMINE 2MG/5ML
VA GENERIC NAME	CHLORPHENIRAMINE/PHENYLEPHRINE/PHENYLPROPANOLAMINE/PHENYLTOLOXAM
DOSAGE FORM	SYRUP
ACTIVE INGREDIENTS	PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 1.25 UNITS: MG/5ML PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG/5ML CHLORPHENIRAMINE MALEATE STRENGTH: 0.5 UNITS: MG/5ML PHENYLTOLOXAMINE DIHYDROGEN CITRATE STRENGTH: 2 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2005-10-14 00:00:00
DSS NUMBER	4
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/PHENYLEPHRINE/PHENYLPROPANOLAMINE/PHENYLTOLOXAM 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	4003830
EFFECTIVE DATE/TIME	2001-01-12 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE