| NAME |
HYDROCODONE 5MG/GG 200MG/PSEUDEFED 60MG/5ML LIQUID |
| VA GENERIC NAME |
GUAIFENESIN/HYDROCODONE/PSEUDOEPHEDRINE |
| DOSAGE FORM |
LIQUID,ORAL |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule II |
| INACTIVATION DATE |
2010-04-07 00:00:00 |
| DSS NUMBER |
2 |
| NATIONAL FORMULARY NAME |
GUAIFENESIN/HYDROCODONE/PSEUDOEPHEDRINE LIQUID,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
HYDROCOD 5MG/GG 200/P-EPHED 60MG/5ML LIQ |
| VA PRODUCT IDENTIFIER |
H0569 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4005673 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2010-04-07 00:00:00
- STATUS: INACTIVE
|
