HYDROCODONE RESIN 5MG/PHENYLTOLOXAMINE RESIN 10MG CAP,SA (3339) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCODONE RESIN 5MG/PHENYLTOLOXAMINE RESIN 10MG CAP,SA
VA GENERIC NAME	HYDROCODONE/PHENYLTOLOXAMINE
DOSAGE FORM	CAP,SA
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	HYDROCODONE RESIN COMPLEX STRENGTH: 5 UNITS: MG PHENYLTOLOXAMINE RESIN COMPLEX STRENGTH: 10 UNITS: MG
CS FEDERAL SCHEDULE	Schedule II
INACTIVATION DATE	2007-09-28 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	HYDROCODONE/PHENYLTOLOXAMINE CAP,SA
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4003909
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-28 00:00:00 STATUS: INACTIVE