HYDROCODONE 2.5MG/APAP 167MG/5ML ELIXIR,15ML (17696) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCODONE 2.5MG/APAP 167MG/5ML ELIXIR,15ML
VA GENERIC NAME	ACETAMINOPHEN/HYDROCODONE
DOSAGE FORM	ELIXIR
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	ACETAMINOPHEN STRENGTH: 167 UNITS: MG/5ML HYDROCODONE STRENGTH: 2.5 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule II
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2016-01-26 00:00:00
NATIONAL FORMULARY NAME	ACETAMINOPHEN/HYDROCODONE 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
VA PRINT NAME	HYDROCODONE 2.5/APAP 167MG/5ML ELIX 15ML
VA PRODUCT IDENTIFIER	H0490
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4025308
EFFECTIVE DATE/TIME	2006-07-20 00:00:00 STATUS: ACTIVE