AMINOPHYLLINE 32MG/AMMONIUM CL 30MG/DIPHENHYDRAMINE 8MG ELIXIR (7439) VA PRODUCT (50.68)

Name	Value
NAME	AMINOPHYLLINE 32MG/AMMONIUM CL 30MG/DIPHENHYDRAMINE 8MG ELIXIR
VA GENERIC NAME	AMINOPHYLLINE/AMMONIUM CHLORIDE/DIPHENHYDRAMINE
DOSAGE FORM	ELIXIR
ACTIVE INGREDIENTS	AMMONIUM CHLORIDE STRENGTH: 30 UNITS: MG ALCOHOL STRENGTH: 5 UNITS: %VV DIPHENHYDRAMINE HYDROCHLORIDE STRENGTH: 8 UNITS: MG AMINOPHYLLINE STRENGTH: 32 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2002-04-04 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	AMINOPHYLLINE/AMMONIUM CHLORIDE/DIPHENHYDRAMINE 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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4007943
EFFECTIVE DATE/TIME	2002-04-04 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE