PHENIRAMINE 12.5MG/P-EPHRINE 5MG/MENTHOL 1MG SYRUP (7212) VA PRODUCT (50.68)

Name	Value
NAME	PHENIRAMINE 12.5MG/P-EPHRINE 5MG/MENTHOL 1MG SYRUP
VA GENERIC NAME	MENTHOL/PHENIRAMINE/PHENYLEPHRINE
DOSAGE FORM	SYRUP
ACTIVE INGREDIENTS	PHENIRAMINE MALEATE STRENGTH: 12.5 UNITS: MG MENTHOL STRENGTH: 1 UNITS: MG PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-10-01 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	MENTHOL/PHENIRAMINE/PHENYLEPHRINE 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	4007720
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-10-01 00:00:00 STATUS: INACTIVE