CODEINE 10MG/P-EPHRINE 5MG/K GUAIACOLSULF 44MG/PROMETH 5MG/5ML (7219) VA PRODUCT (50.68)

Name	Value
NAME	CODEINE 10MG/P-EPHRINE 5MG/K GUAIACOLSULF 44MG/PROMETH 5MG/5ML
VA GENERIC NAME	CODEINE/PHENYLEPHRINE/POTASSIUM GUAIACOLSULFONATE/PROMETHAZINE
DOSAGE FORM	LIQUID,ORAL
HAZARDOUS TO DISPOSE	NO
DOT SHIPPING CODE
ACTIVE INGREDIENTS	POTASSIUM GUAIACOLSULFONATE STRENGTH: 44 UNITS: MG ALCOHOL STRENGTH: 7 UNITS: %VV PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG PROMETHAZINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG CODEINE PHOSPHATE STRENGTH: 10 UNITS: MG
CS FEDERAL SCHEDULE	Schedule V
INACTIVATION DATE	2008-09-02 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	CODEINE/PHENYLEPHRINE/POTASSIUM GUAIACOLSULFONATE/PROMETHAZINE 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	4007727
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2008-09-02 00:00:00 STATUS: INACTIVE