HYDROCODONE 1.67MG/CTM 2MG/P-EPHRINE 5MG/5ML LIQUID (6599) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCODONE 1.67MG/CTM 2MG/P-EPHRINE 5MG/5ML LIQUID
VA GENERIC NAME	CHLORPHENIRAMINE/HYDROCODONE/PHENYLEPHRINE
DOSAGE FORM	LIQUID,ORAL
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	HYDROCODONE BITARTRATE STRENGTH: 10 UNITS: MG PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 30 UNITS: MG CHLORPHENIRAMINE MALEATE STRENGTH: 12 UNITS: MG
CS FEDERAL SCHEDULE	Schedule II
INACTIVATION DATE	2010-04-07 00:00:00
DSS NUMBER	3
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/HYDROCODONE/PHENYLEPHRINE 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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4007115
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2010-04-07 00:00:00 STATUS: INACTIVE