TRIAMINIC EXPECTORANT DH (4407) VA PRODUCT (50.68)

Name	Value
NAME	TRIAMINIC EXPECTORANT DH
VA GENERIC NAME	GUAIFENESIN/HYDROCODONE/PHENIRAMINE/PHENYLPROPANOLAMINE/PYRILAMI
DOSAGE FORM	LIQUID
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	PHENIRAMINE MALEATE STRENGTH: 6.25 UNITS: MG/5ML HYDROCODONE BITARTRATE STRENGTH: 1.67 UNITS: MG/5ML ALCOHOL STRENGTH: 5 UNITS: %VV PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 12.5 UNITS: MG/5ML SORBITOL SACCHARIN GUAIFENESIN STRENGTH: 100 UNITS: MG/5ML PYRILAMINE MALEATE STRENGTH: 6.25 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule III Non-Narcotics
INACTIVATION DATE	2005-10-14 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	GUAIFENESIN/HYDROCODONE/PHENIRAMINE/PHENYLPROPANOLAMINE/PYRILAMI LIQUID
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	4004954
EFFECTIVE DATE/TIME	2002-10-04 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE