HYDROCODONE 5MG/PHENYLTOLOXAMINE 10MG/5ML SUSP (3341) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCODONE 5MG/PHENYLTOLOXAMINE 10MG/5ML SUSP
VA GENERIC NAME	HYDROCODONE/PHENYLTOLOXAMINE
DOSAGE FORM	SUSP
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	PHENYLTOLOXAMINE STRENGTH: 10 UNITS: MG/5ML HYDROCODONE STRENGTH: 5 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule II
INACTIVATION DATE	2007-09-28 00:00:00
DSS NUMBER	3
NATIONAL FORMULARY NAME	HYDROCODONE/PHENYLTOLOXAMINE SUSP
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	4003911
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-28 00:00:00 STATUS: INACTIVE