BPM 2MG/DM 10MG/P-PROPANOL 12.5MG/5ML (AF) ELIXIR (7135) VA PRODUCT (50.68)

Name	Value
NAME	BPM 2MG/DM 10MG/P-PROPANOL 12.5MG/5ML (AF) ELIXIR
VA GENERIC NAME	BROMPHENIRAMINE/DEXTROMETHORPHAN/PHENYLPROPANOLAMINE
DOSAGE FORM	ELIXIR
ACTIVE INGREDIENTS	BROMPHENIRAMINE MALEATE STRENGTH: 2 UNITS: MG/5ML PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 12.5 UNITS: MG/5ML DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 10 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2005-10-14 00:00:00
DSS NUMBER	3
NATIONAL FORMULARY NAME	BROMPHENIRAMINE/DEXTROMETHORPHAN/PHENYLPROPANOLAMINE 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
VA PRINT NAME	BPM 2/DM 10/PPA 12.5MG/5ML AF ELIXIR
VA PRODUCT IDENTIFIER	B0378
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4007645
EFFECTIVE DATE/TIME	2001-01-12 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE