DIHYDROCODEINE 3MG/CTM 5MG/P-EPHRINE 20MG/P-PROPANOL 20MG/5ML SY (6610) VA PRODUCT (50.68)

Name	Value
NAME	DIHYDROCODEINE 3MG/CTM 5MG/P-EPHRINE 20MG/P-PROPANOL 20MG/5ML SY
VA GENERIC NAME	CHLORPHENIRAMINE/DIHYDROCODEINE/PHENYLEPHRINE/PHENYLPROPANOLAMIN
DOSAGE FORM	SYRUP
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 20 UNITS: MG/5ML PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 20 UNITS: MG/5ML CHLORPHENIRAMINE MALEATE STRENGTH: 5 UNITS: MG/5ML DIHYDROCODEINE BITARTRATE STRENGTH: 3 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule V
INACTIVATION DATE	2005-10-14 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/DIHYDROCODEINE/PHENYLEPHRINE/PHENYLPROPANOLAMIN 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	4007126
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2005-10-14 00:00:00 STATUS: INACTIVE