HYDROCODONE 2.5MG/GUAIFENESIN 200MG/5ML SOLN,ORAL (25378) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCODONE 2.5MG/GUAIFENESIN 200MG/5ML SOLN,ORAL
VA GENERIC NAME	GUAIFENESIN/HYDROCODONE
DOSAGE FORM	SOLN,ORAL
FDA MED GUIDE	Hydrocodone-Guaifenesin_(Obredon)_(2018).pdf
ACTIVE INGREDIENTS	HYDROCODONE BITARTRATE STRENGTH: 2.5 UNITS: MG/5ML GUAIFENESIN STRENGTH: 200 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule II
INACTIVATION DATE	2023-05-15 00:00:00
NATIONAL FORMULARY NAME	GUAIFENESIN/HYDROCODONE SOLN,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00 COPAY END DATE: 2018-10-24 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2018-10-25 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	HYDROCODONE 2.5MG/GUAIFEN 200MG/5ML SOLN
VA PRODUCT IDENTIFIER	H0680
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4034091
EFFECTIVE DATE/TIME	2015-01-23 00:00:00 STATUS: ACTIVE 2023-05-15 00:00:00 STATUS: INACTIVE