CODEINE 10MG/CTM 4MG/P-EPHRINE 10MG/5ML LIQUID (28843) VA PRODUCT (50.68)

Name	Value
NAME	CODEINE 10MG/CTM 4MG/P-EPHRINE 10MG/5ML LIQUID
VA GENERIC NAME	CHLORPHENIRAMINE/CODEINE/PHENYLEPHRINE
DOSAGE FORM	LIQUID
ACTIVE INGREDIENTS	PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 10 UNITS: MG/5ML CHLORPHENIRAMINE MALEATE STRENGTH: 4 UNITS: MG/5ML CODEINE PHOSPHATE STRENGTH: 10 UNITS: MG/5ML
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/CODEINE/PHENYLEPHRINE LIQUID
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2018-10-12 00:00:00
PGX ELIGIBLE	YES
PGX SUPPRESSED	YES
VA PRINT NAME	CODEINE 10/CPM 4/PHENYLEPH 10MG/5ML LIQ
VA PRODUCT IDENTIFIER	C1869
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4037922
EFFECTIVE DATE/TIME	2018-10-15 00:00:00 STATUS: ACTIVE