CODEINE POLISTIREX 14.7MG/CHLORPHENIRAMINE 2.8MG/5ML SUSP,SA (25782) VA PRODUCT (50.68)

Name	Value
NAME	CODEINE POLISTIREX 14.7MG/CHLORPHENIRAMINE 2.8MG/5ML SUSP,SA
VA GENERIC NAME	CHLORPHENIRAMINE/CODEINE
DOSAGE FORM	SUSP,SA
FDA MED GUIDE	Codeine-Chlorpheneramine_SA_Susp_(Tuzistra_XR)_(2018).pdf
ACTIVE INGREDIENTS	CHLORPHENIRAMINE POLISTIREX STRENGTH: 2.8 UNITS: MG/5ML CODEINE POLISTIREX STRENGTH: 14.7 UNITS: MG/5ML
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/CODEINE SUSP,SA
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	CODEINE POLI 14.7/CTM 2.8MG/5ML SA SUSP
VA PRODUCT IDENTIFIER	C1716
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4034533
EFFECTIVE DATE/TIME	2015-06-23 00:00:00 STATUS: ACTIVE