EPHEDRINE 36MG/PHENOBARB 12MG/THEOPHYLLINE 177MG/15ML SUSP (6630) VA PRODUCT (50.68)

Name	Value
NAME	EPHEDRINE 36MG/PHENOBARB 12MG/THEOPHYLLINE 177MG/15ML SUSP
VA GENERIC NAME	EPHEDRINE/PHENOBARBITAL/THEOPHYLLINE
DOSAGE FORM	SUSP
ACTIVE INGREDIENTS	EPHEDRINE HYDROCHLORIDE STRENGTH: 36 UNITS: MG/15ML PHENOBARBITAL STRENGTH: 12 UNITS: MG/15ML THEOPHYLLINE STRENGTH: 177.3 UNITS: MG/15ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2003-07-31 00:00:00
DSS NUMBER	5
NATIONAL FORMULARY NAME	EPHEDRINE/PHENOBARBITAL/THEOPHYLLINE SUSP
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	4007146
EFFECTIVE DATE/TIME	2003-07-31 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE