PSEUDOEPHEDRINE HCL 30MG/TRIPROLIDINE HCL 1.25MG/5ML SYRUP (4611) VA PRODUCT (50.68)

Name	Value
NAME	PSEUDOEPHEDRINE HCL 30MG/TRIPROLIDINE HCL 1.25MG/5ML SYRUP
VA GENERIC NAME	PSEUDOEPHEDRINE/TRIPROLIDINE
DOSAGE FORM	SYRUP
ACTIVE INGREDIENTS	TRIPROLIDINE HYDROCHLORIDE STRENGTH: 2.5 UNITS: MG/10ML PSEUDOEPHEDRINE HYDROCHLORIDE STRENGTH: 60 UNITS: MG/10ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	1
NATIONAL FORMULARY NAME	PSEUDOEPHEDRINE/TRIPROLIDINE 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
VA PRINT NAME	PSEUDO 30/TRIPROLIDINE 1.25MG/5ML SYRUP
VA PRODUCT IDENTIFIER	P0409
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4005158
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE