| NAME |
CODEINE 30MG/APAP 300MG/BUTALBITAL 50MG/CAFN 40MG CAP |
| VA GENERIC NAME |
ACETAMINOPHEN/BUTALBITAL/CAFFEINE/CODEINE |
| DOSAGE FORM |
CAP,ORAL |
| FDA MED GUIDE |
Codeine-Acetaminophen-Butalbital-Caffeine_(Generic)_(2021).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule III |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
ACETAMINOPHEN/BUTALBITAL/CAFFEINE/CODEINE CAP,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| 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 30/APAP 300/BUTALB 50MG/CAFN CAP |
| VA PRODUCT IDENTIFIER |
C1578 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
CAP |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4032595 |
| EFFECTIVE DATE/TIME |
-
- 2013-08-01 00:00:00
- STATUS: ACTIVE
|