HYDROCODONE 2.5MG/CTM 4MG/P-EPHRINE 10MG/5ML LIQUID (6600) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCODONE 2.5MG/CTM 4MG/P-EPHRINE 10MG/5ML LIQUID
VA GENERIC NAME	CHLORPHENIRAMINE/HYDROCODONE/PHENYLEPHRINE
DOSAGE FORM	ELIXIR
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	HYDROCODONE BITARTRATE STRENGTH: 2.5 UNITS: MG/5ML PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 10 UNITS: MG/5ML CHLORPHENIRAMINE MALEATE STRENGTH: 4 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule II
INACTIVATION DATE	2010-04-07 00:00:00
DSS NUMBER	4
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/HYDROCODONE/PHENYLEPHRINE 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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4007116
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2010-04-07 00:00:00 STATUS: INACTIVE