PHENIRAMINE 4MG/P-PROPANOL 12.5MG/P-TOLOX 4MG/PYRILAMINE 4MG/5ML (6415) VA PRODUCT (50.68)

Name	Value
NAME	PHENIRAMINE 4MG/P-PROPANOL 12.5MG/P-TOLOX 4MG/PYRILAMINE 4MG/5ML
VA GENERIC NAME	PHENIRAMINE/PHENYLPROPANOLAMINE/PHENYLTOLOXAMINE/PYRILAMINE
DOSAGE FORM	ELIXIR
ACTIVE INGREDIENTS	PHENIRAMINE MALEATE STRENGTH: 4 UNITS: MG/5ML ALCOHOL STRENGTH: 4 UNITS: % PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 12.5 UNITS: MG/5ML PHENYLTOLOXAMINE DIHYDROGEN CITRATE STRENGTH: 4 UNITS: MG/5ML PYRILAMINE MALEATE STRENGTH: 4 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2005-10-14 00:00:00
DSS NUMBER	4
NATIONAL FORMULARY NAME	PHENIRAMINE/PHENYLPROPANOLAMINE/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	4006935
EFFECTIVE DATE/TIME	2002-04-04 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE