EPHEDRINE 24MG/PHENOBARB 24MG/KI 320MG/THEOPHYLLINE 130MG TAB (4425) VA PRODUCT (50.68)

Name	Value
NAME	EPHEDRINE 24MG/PHENOBARB 24MG/KI 320MG/THEOPHYLLINE 130MG TAB
VA GENERIC NAME	EPHEDRINE/PHENOBARBITAL/POTASSIUM IODIDE/THEOPHYLLINE
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	EPHEDRINE HYDROCHLORIDE STRENGTH: 24 UNITS: MG THEOPHYLLINE CALCIUM SALICYLATE STRENGTH: 130 UNITS: MG PHENOBARBITAL STRENGTH: 24 UNITS: MG POTASSIUM IODIDE STRENGTH: 320 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2003-07-31 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	EPHEDRINE/PHENOBARBITAL/POTASSIUM IODIDE/THEOPHYLLINE TAB
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	4004972
EFFECTIVE DATE/TIME	2003-07-31 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE