CODEINE 10MG/APAP 300MG/GG 100MG/P-PROPANOL 25MG TAB (6678) VA PRODUCT (50.68)

Name	Value
NAME	CODEINE 10MG/APAP 300MG/GG 100MG/P-PROPANOL 25MG TAB
VA GENERIC NAME	ACETAMINOPHEN/CODEINE/GUAIFENESIN/PHENYLPROPANOLAMINE
DOSAGE FORM	TAB
HAZARDOUS TO DISPOSE	YES
WASTE SORT CODE	DEA
ACTIVE INGREDIENTS	ACETAMINOPHEN STRENGTH: 300 UNITS: MG PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 25 UNITS: MG CODEINE PHOSPHATE STRENGTH: 10 UNITS: MG GUAIFENESIN STRENGTH: 100 UNITS: MG
CS FEDERAL SCHEDULE	Schedule V
INACTIVATION DATE	2005-10-14 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	ACETAMINOPHEN/CODEINE/GUAIFENESIN/PHENYLPROPANOLAMINE TAB
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
VA PRINT NAME	CODEINE 10/APAP 300/GG 100/PPA 25MG TAB
VA PRODUCT IDENTIFIER	C0776
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4007194
EFFECTIVE DATE/TIME	2001-01-12 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE