HYFED SYRUP (7615) VA PRODUCT (50.68)

Name	Value
NAME	HYFED SYRUP
VA GENERIC NAME	CHLORPHENIRAMINE/HYDROCODONE/NH4/PHENINDAMINE/PHENYLEPHRINE/PYRI
DOSAGE FORM	LIQUID,ORAL
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	HYDROCODONE BITARTRATE STRENGTH: 2.5 UNITS: MG/5ML AMMONIUM CHLORIDE STRENGTH: 50 UNITS: MG/5ML PHENINDAMINE TARTRATE STRENGTH: 5 UNITS: MG/5ML ALCOHOL STRENGTH: 5 UNITS: % PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG/5ML CHLORPHENIRAMINE MALEATE STRENGTH: 2 UNITS: MG/5ML PYRILAMINE MALEATE STRENGTH: 6 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule III Non-Narcotics
INACTIVATION DATE	2007-09-28 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/HYDROCODONE/NH4/PHENINDAMINE/PHENYLEPHRINE/PYRI 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	4008111
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-28 00:00:00 STATUS: INACTIVE