DIPHENHYDRAMINE 12.5MG/PSEUDOEPHEDRINE 30MG/5ML ELIXIR (9287) VA PRODUCT (50.68)

Name	Value
NAME	DIPHENHYDRAMINE 12.5MG/PSEUDOEPHEDRINE 30MG/5ML ELIXIR
VA GENERIC NAME	DIPHENHYDRAMINE/PSEUDOEPHEDRINE
DOSAGE FORM	ELIXIR
ACTIVE INGREDIENTS	DIPHENHYDRAMINE HYDROCHLORIDE STRENGTH: 12.5 UNITS: MG/5ML PSEUDOEPHEDRINE HYDROCHLORIDE STRENGTH: 30 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2010-11-30 00:00:00
DSS NUMBER	4
NATIONAL FORMULARY NAME	DIPHENHYDRAMINE/PSEUDOEPHEDRINE 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	4009713
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2010-11-30 00:00:00 STATUS: INACTIVE