| NAME |
DIHYDROCODEINE 16MG/APAP 356MG/CAFN 30MG CAP |
| VA GENERIC NAME |
ACETAMINOPHEN/CAFFEINE/DIHYDROCODEINE |
| DOSAGE FORM |
CAP,ORAL |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule III |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| INACTIVATION DATE |
2015-06-10 00:00:00 |
| DSS NUMBER |
1 |
| NATIONAL FORMULARY NAME |
ACETAMINOPHEN/CAFFEINE/DIHYDROCODEINE 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 |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DIHYDROCODEINE 16/APAP 356/CAFF 30MG CAP |
| VA PRODUCT IDENTIFIER |
D0358 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
CAP |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4003400 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
|
