BELLADONNA ALKALOIDS 0.218MG/PHENOBARBITAL 21.6MG/5ML ELIXIR (4071) VA PRODUCT (50.68)

Name	Value
NAME	BELLADONNA ALKALOIDS 0.218MG/PHENOBARBITAL 21.6MG/5ML ELIXIR
VA GENERIC NAME	ATROPINE/HYOSCYAMINE/PHENOBARBITAL/SCOPOLAMINE
DOSAGE FORM	ELIXIR
ACTIVE INGREDIENTS	ATROPINE SULFATE STRENGTH: 0.034 UNITS: MG/5ML PHENOBARBITAL STRENGTH: 21.6 UNITS: MG/5ML HYOSCYAMINE SULFATE STRENGTH: 0.174 UNITS: MG/5ML SCOPOLAMINE HYDROBROMIDE STRENGTH: 0.01 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	6
NATIONAL FORMULARY NAME	ATROPINE/HYOSCYAMINE/PHENOBARBITAL/SCOPOLAMINE ELIXIR
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	BELLADONNA ALK 0.22/PHENOBARB 22MG/5ML
VA PRODUCT IDENTIFIER	B0333
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4004624
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE