AMMONIUM CL 125MG/DIPHENHYDRAMINE 12.5MG/MENTHOL/NA CIT/5ML LIQ (6408) VA PRODUCT (50.68)

Name	Value
NAME	AMMONIUM CL 125MG/DIPHENHYDRAMINE 12.5MG/MENTHOL/NA CIT/5ML LIQ
VA GENERIC NAME	AMMONIUM CHLORIDE/DIPHENHYDRAMINE/MENTHOL/SODIUM CITRATE
DOSAGE FORM	LIQUID,ORAL
ACTIVE INGREDIENTS	AMMONIUM CHLORIDE STRENGTH: 778 UNITS: MG MENTHOL STRENGTH: 6.4 UNITS: MG ALCOHOL,DENATURED STRENGTH: 5 UNITS: % DIPHENHYDRAMINE HYDROCHLORIDE STRENGTH: 80 UNITS: MG SODIUM CITRATE STRENGTH: 324 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2002-04-04 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	AMMONIUM CHLORIDE/DIPHENHYDRAMINE/MENTHOL/SODIUM CITRATE LIQUID,ORAL
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	4006928
EFFECTIVE DATE/TIME	2002-04-04 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE