PHENIRAMINE 4MG/P-TOLOXAMINE 4MG/PYRILAMINE 4MG/5ML ELIXIR (6411) VA PRODUCT (50.68)

Name	Value
NAME	PHENIRAMINE 4MG/P-TOLOXAMINE 4MG/PYRILAMINE 4MG/5ML ELIXIR
VA GENERIC NAME	PHENIRAMINE/PHENYLTOLOXAMINE/PYRILAMINE
DOSAGE FORM	ELIXIR
ACTIVE INGREDIENTS	PHENIRAMINE MALEATE STRENGTH: 4 UNITS: MG PHENYLTOLOXAMINE DIHYDROGEN CITRATE STRENGTH: 4 UNITS: MG PYRILAMINE MALEATE STRENGTH: 4 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2010-02-22 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	PHENIRAMINE/PHENYLTOLOXAMINE/PYRILAMINE 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	4006931
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2010-02-22 00:00:00 STATUS: INACTIVE