HYDROCODONE 5MG/ACETAMINOPHEN 500MG/5ML ELIXIR (4421) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCODONE 5MG/ACETAMINOPHEN 500MG/5ML ELIXIR
VA GENERIC NAME	ACETAMINOPHEN/HYDROCODONE
DOSAGE FORM	ELIXIR
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	ACETAMINOPHEN STRENGTH: 500 UNITS: MG/5ML HYDROCODONE BITARTRATE STRENGTH: 5 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule II
INACTIVATION DATE	2007-09-20 00:00:00
DSS NUMBER	12
NATIONAL FORMULARY NAME	ACETAMINOPHEN/HYDROCODONE ELIXIR
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 5/APAP 500MG/5ML ELIXIR
VA PRODUCT IDENTIFIER	H0254
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4004968
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-20 00:00:00 STATUS: INACTIVE