HYDROCODONE 2.5MG/CTM 2MG/P-EPHRINE 5MG/5ML SYRUP (6601) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCODONE 2.5MG/CTM 2MG/P-EPHRINE 5MG/5ML SYRUP
VA GENERIC NAME	CHLORPHENIRAMINE/HYDROCODONE/PHENYLEPHRINE
DOSAGE FORM	SYRUP
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	HYDROCODONE BITARTRATE STRENGTH: 2.5 UNITS: MG/5ML PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG/5ML CHLORPHENIRAMINE MALEATE STRENGTH: 2 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule II
INACTIVATION DATE	2009-12-01 00:00:00
DSS NUMBER	5
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/HYDROCODONE/PHENYLEPHRINE SYRUP
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	4007117
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2009-12-01 00:00:00 STATUS: INACTIVE