HYDROCODONE 2.5MG/ACETAMINOPHEN 120MG/5ML ELIXIR (4415)    VA PRODUCT (50.68)

Name Value
NAME HYDROCODONE 2.5MG/ACETAMINOPHEN 120MG/5ML ELIXIR
VA GENERIC NAME ACETAMINOPHEN/HYDROCODONE
DOSAGE FORM ELIXIR
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Schedule II
INACTIVATION DATE 2007-09-20 00:00:00
DSS NUMBER 6
NATIONAL FORMULARY NAME ACETAMINOPHEN/HYDROCODONE 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 HYDROCODONE 2.5/APAP 120MG/5ML ELIXIR
VA PRODUCT IDENTIFIER H0313
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4004962
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-20 00:00:00
    STATUS:   INACTIVE