HYDROCODONE 5MG/GUAIFENESIN 300MG (M-PHASE) CAP,SA (17625) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCODONE 5MG/GUAIFENESIN 300MG (M-PHASE) CAP,SA
VA GENERIC NAME	GUAIFENESIN/HYDROCODONE
DOSAGE FORM	CAP,SA
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	GUAIFENESIN STRENGTH: 300 UNITS: MG HYDROCODONE STRENGTH: 5 UNITS: MG
CS FEDERAL SCHEDULE	Schedule II
INACTIVATION DATE	2010-01-08 00:00:00
NATIONAL FORMULARY NAME	GUAIFENESIN/HYDROCODONE CAP,SA
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 5MG/GG 300MG(M-PHASE) SA CAP
VA PRODUCT IDENTIFIER	H0484
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4025157
EFFECTIVE DATE/TIME	2006-05-22 00:00:00 STATUS: ACTIVE 2010-01-08 00:00:00 STATUS: INACTIVE