HYDROCODONE 5MG/GUAIFENESIN 300MG TAB (4662)    VA PRODUCT (50.68)

Name Value
NAME HYDROCODONE 5MG/GUAIFENESIN 300MG TAB
VA GENERIC NAME GUAIFENESIN/HYDROCODONE
DOSAGE FORM TAB
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Schedule II
INACTIVATION DATE 2010-06-14 00:00:00
DSS NUMBER 2
NATIONAL FORMULARY NAME GUAIFENESIN/HYDROCODONE TAB
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 5MG/GUAIFENESIN 300MG TAB
VA PRODUCT IDENTIFIER H0226
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4005209
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2010-06-14 00:00:00
    STATUS:   INACTIVE