CODEINE 2.5MG/GUAIFENESIN 75MG/5ML LIQUID (4170)    VA PRODUCT (50.68)

Name Value
NAME CODEINE 2.5MG/GUAIFENESIN 75MG/5ML LIQUID
VA GENERIC NAME CODEINE/GUAIFENESIN
DOSAGE FORM LIQUID,ORAL
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Schedule V
INACTIVATION DATE 2011-06-02 00:00:00
DSS NUMBER 3
NATIONAL FORMULARY NAME CODEINE/GUAIFENESIN LIQUID,ORAL
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
VA PRINT NAME CODEINE 2.5/GUAIFENESIN 75MG/5ML LIQUID
VA PRODUCT IDENTIFIER C0625
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4004722
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2011-06-02 00:00:00
    STATUS:   INACTIVE