B-DONNA 0.24MG/CTM 8MG/P-EPHRINE 25MG/P-PROPANOL 50MG TAB,SA (7086) VA PRODUCT (50.68)

Name	Value
NAME	B-DONNA 0.24MG/CTM 8MG/P-EPHRINE 25MG/P-PROPANOL 50MG TAB,SA
VA GENERIC NAME	BELLADONNA/CHLORPHENIRAMINE/PHENYLEPHRINE/PHENYLPROPANOLAMINE
DOSAGE FORM	TAB,SA
ACTIVE INGREDIENTS	ATROPINE SULFATE STRENGTH: 0.0362 UNITS: MG PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 25 UNITS: MG PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 50 UNITS: MG CHLORPHENIRAMINE MALEATE STRENGTH: 8 UNITS: MG HYOSCYAMINE SULFATE STRENGTH: 0.1936 UNITS: MG SCOPOLAMINE HYDROBROMIDE STRENGTH: 0.0121 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2005-10-14 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	BELLADONNA/CHLORPHENIRAMINE/PHENYLEPHRINE/PHENYLPROPANOLAMINE TAB,SA
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
VA PRINT NAME	ATROHIST PLUS SA TAB
VA PRODUCT IDENTIFIER	A0707
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4007596
EFFECTIVE DATE/TIME	2002-04-04 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE