PHENYLEPHRINE HCL 0.125%/SULFACETAMIDE NA 15% SOLN,OPH (8791) VA PRODUCT (50.68)

Name	Value
NAME	PHENYLEPHRINE HCL 0.125%/SULFACETAMIDE NA 15% SOLN,OPH
VA GENERIC NAME	PHENYLEPHRINE/SULFACETAMIDE
DOSAGE FORM	SOLN,OPH
ACTIVE INGREDIENTS	PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 0.125 UNITS: % SULFACETAMIDE SODIUM STRENGTH: 15 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-24 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	PHENYLEPHRINE/SULFACETAMIDE 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	PHENYLEPHR 0.125/SULFACET 15% OPH SOLN
VA PRODUCT IDENTIFIER	P0238
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4009248
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-24 00:00:00 STATUS: INACTIVE