HYDROCODONE BITARTRATE 7.5MG/IBUPROFEN 200MG TAB (12782)    VA PRODUCT (50.68)

Name Value
NAME HYDROCODONE BITARTRATE 7.5MG/IBUPROFEN 200MG TAB
VA GENERIC NAME HYDROCODONE/IBUPROFEN
DOSAGE FORM TAB
FDA MED GUIDE Hydrocodone-Ibuprofen_(Vicoprofen)_(2016).pdf
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Schedule II
SINGLE/MULTI SOURCE PRODUCT Multisource
DSS NUMBER 1
NATIONAL FORMULARY NAME HYDROCODONE/IBUPROFEN TAB
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 YES
PGX SUPPRESSED NO
VA PRINT NAME HYDROCODONE 7.5/IBUPROFEN 200MG TAB
VA PRODUCT IDENTIFIER H0310
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4013147
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE