P-EPHRINE 5MG/K GUAIACOLSULF 44MG/PROMETH 5MG/5ML SYRUP (7048) VA PRODUCT (50.68)

Name	Value
NAME	P-EPHRINE 5MG/K GUAIACOLSULF 44MG/PROMETH 5MG/5ML SYRUP
VA GENERIC NAME	PHENYLEPHRINE/POTASSIUM GUAIACOLSULFONATE/PROMETHAZINE
DOSAGE FORM	SYRUP
ACTIVE INGREDIENTS	POTASSIUM GUAIACOLSULFONATE STRENGTH: 44 UNITS: MG PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG PROMETHAZINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-10-01 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	PHENYLEPHRINE/POTASSIUM GUAIACOLSULFONATE/PROMETHAZINE SYRUP
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	4007558
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-10-01 00:00:00 STATUS: INACTIVE