| NAME |
CODEINE 10MG/GUAIFENESIN 100MG/5ML (SF) LIQUID,ORAL |
| VA GENERIC NAME |
CODEINE/GUAIFENESIN |
| DOSAGE FORM |
LIQUID,ORAL |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule V |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
CODEINE/GUAIFENESIN LIQUID,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 10/GG 100MG/5ML (SF) ORAL LIQ |
| VA PRODUCT IDENTIFIER |
C1600 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4032876 |
| EFFECTIVE DATE/TIME |
-
- 2013-11-22 00:00:00
- STATUS: ACTIVE
|
