BUTABARB 20MG/EPHEDRINE 25MG/GG 100MG/THEOPHYLLINE 150MG/15ML EL (6107) VA PRODUCT (50.68)

Name	Value
NAME	BUTABARB 20MG/EPHEDRINE 25MG/GG 100MG/THEOPHYLLINE 150MG/15ML EL
VA GENERIC NAME	BUTABARBITAL/EPHEDRINE/GUAIFENESIN/THEOPHYLLINE
DOSAGE FORM	ELIXIR
ACTIVE INGREDIENTS	BUTABARBITAL SODIUM STRENGTH: 20 UNITS: MG/15ML EPHEDRINE HYDROCHLORIDE STRENGTH: 25 UNITS: MG/15ML ALCOHOL STRENGTH: 15 UNITS: % THEOPHYLLINE STRENGTH: 150 UNITS: MG/15ML GUAIFENESIN STRENGTH: 100 UNITS: MG/15ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2002-04-04 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	BUTABARBITAL/EPHEDRINE/GUAIFENESIN/THEOPHYLLINE 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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4006628
EFFECTIVE DATE/TIME	2002-04-04 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE