CODEINE 10MG/BPM 2MG/P-PROPANOL 12.5MG/5ML SYRUP (1901) VA PRODUCT (50.68)

Name	Value
NAME	CODEINE 10MG/BPM 2MG/P-PROPANOL 12.5MG/5ML SYRUP
VA GENERIC NAME	BROMPHENIRAMINE/CODEINE/PHENYLPROPANOLAMINE
DOSAGE FORM	SYRUP
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	BROMPHENIRAMINE MALEATE STRENGTH: 2 UNITS: MG/5ML PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 12.5 UNITS: MG/5ML CODEINE PHOSPHATE STRENGTH: 10 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule V
INACTIVATION DATE	2005-10-14 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	BROMPHENIRAMINE/CODEINE/PHENYLPROPANOLAMINE 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	NO
PGX SUPPRESSED	NO
VA PRINT NAME	CODEINE 10/BPM 2/PPA 12.5MG/5ML SYRUP
VA PRODUCT IDENTIFIER	C0777
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4002486
EFFECTIVE DATE/TIME	2001-01-12 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE