PHENIRAMINE MALEATE 0.5%/PHENYLEPHRINE HCL 0.125% SOLN,OPH (7222)    VA PRODUCT (50.68)

Name Value
NAME PHENIRAMINE MALEATE 0.5%/PHENYLEPHRINE HCL 0.125% SOLN,OPH
VA GENERIC NAME PHENIRAMINE/PHENYLEPHRINE
DOSAGE FORM SOLN,OPH
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2003-08-01 00:00:00
DSS NUMBER 2
NATIONAL FORMULARY NAME PHENIRAMINE/PHENYLEPHRINE SOLN,OPH
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 PHENIRAMIN 0.5/PHENYLEPH 0.125% OPH SOLN
VA PRODUCT IDENTIFIER P0234
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4007730
EFFECTIVE DATE/TIME
  • 2003-08-01 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE