HYDROCODONE 5MG/GG 100MG/P-EPHINE 7.5MG/5ML SYRUP (17481) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCODONE 5MG/GG 100MG/P-EPHINE 7.5MG/5ML SYRUP
VA GENERIC NAME	GUAIFENESIN/HYDROCODONE/PHENYLEPHRINE
DOSAGE FORM	SYRUP,ORAL
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	PHENYLEPHRINE STRENGTH: 7.5 UNITS: MG/5ML GUAIFENESIN STRENGTH: 100 UNITS: MG/5ML HYDROCODONE STRENGTH: 5 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule II
INACTIVATION DATE	2010-04-07 00:00:00
NATIONAL FORMULARY NAME	GUAIFENESIN/HYDROCODONE/PHENYLEPHRINE SYRUP,ORAL
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	HYDROCODONE 5/GG 100/P-EPHINE 7.5/5ML
VA PRODUCT IDENTIFIER	H0480
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4024982
EFFECTIVE DATE/TIME	2006-03-28 00:00:00 STATUS: ACTIVE 2010-04-07 00:00:00 STATUS: INACTIVE