CTM 12MG/P-EPHRINE 25MG/P-PROPANOL 50MG/P-TOLOXAMINE 30MG CAP,SA (3264) VA PRODUCT (50.68)

Name	Value
NAME	CTM 12MG/P-EPHRINE 25MG/P-PROPANOL 50MG/P-TOLOXAMINE 30MG CAP,SA
VA GENERIC NAME	CHLORPHENIRAMINE/PHENYLEPHRINE/PHENYLPROPANOLAMINE/PHENYLTOLOXAM
DOSAGE FORM	CAP,SA
ACTIVE INGREDIENTS	PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 25 UNITS: MG PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 50 UNITS: MG CHLORPHENIRAMINE MALEATE STRENGTH: 12 UNITS: MG PHENYLTOLOXAMINE DIHYDROGEN CITRATE STRENGTH: 30 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2005-10-14 00:00:00
DSS NUMBER	8
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/PHENYLEPHRINE/PHENYLPROPANOLAMINE/PHENYLTOLOXAM CAP,SA
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	4003834
EFFECTIVE DATE/TIME	2001-01-12 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE