CODEINE 10MG/P-EPHRINE 5MG/PROMETH 6.25MG/5ML SYRUP (1866) VA PRODUCT (50.68)

Name	Value
NAME	CODEINE 10MG/P-EPHRINE 5MG/PROMETH 6.25MG/5ML SYRUP
VA GENERIC NAME	CODEINE/PHENYLEPHRINE/PROMETHAZINE
DOSAGE FORM	SYRUP
FDA MED GUIDE	Codeine-Phenylephrine-Promethazine_Liq_(Generic)_(Aug_2017).pdf
HAZARDOUS TO DISPOSE	NO
DOT SHIPPING CODE
ACTIVE INGREDIENTS	PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG/5ML PROMETHAZINE HYDROCHLORIDE STRENGTH: 6.25 UNITS: MG/5ML CODEINE PHOSPHATE STRENGTH: 10 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule V
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	1
NATIONAL FORMULARY NAME	CODEINE/PHENYLEPHRINE/PROMETHAZINE SYRUP
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	YES
VA PRINT NAME	CODEINE 10/P-E 5/PROMETH 6.25MG/5ML SYR
VA PRODUCT IDENTIFIER	C1808
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4002451
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE