CTM 0.06%/HC 0.5%/PHENIRAMINE 0.2%/PYRILAMINE 0.2% LOTION (9958) VA PRODUCT (50.68)

Name	Value
NAME	CTM 0.06%/HC 0.5%/PHENIRAMINE 0.2%/PYRILAMINE 0.2% LOTION
VA GENERIC NAME	CHLORPHENIRAMINE/HYDROCORTISONE/PHENIRAMINE/PYRILAMINE
DOSAGE FORM	LOTION
ACTIVE INGREDIENTS	PHENIRAMINE MALEATE STRENGTH: 0.2 UNITS: % BENZYL ALCOHOL STRENGTH: 1 UNITS: % CHLORPHENIRAMINE STRENGTH: 0.06 UNITS: % HYDROCORTISONE STRENGTH: 0.5 UNITS: % PYRILAMINE MALEATE STRENGTH: 0.2 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2008-09-30 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/HYDROCORTISONE/PHENIRAMINE/PYRILAMINE LOTION
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	4010349
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2008-09-30 00:00:00 STATUS: INACTIVE