CODEINE 10MG/CTM 2MG/P-PROPANOL 18.75MG/5ML ELIXIR (7624) VA PRODUCT (50.68)

Name	Value
NAME	CODEINE 10MG/CTM 2MG/P-PROPANOL 18.75MG/5ML ELIXIR
VA GENERIC NAME	CHLORPHENIRAMINE/CODEINE/PHENYLPROPANOLAMINE
DOSAGE FORM	ELIXIR
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 18.75 UNITS: MG CHLORPHENIRAMINE MALEATE STRENGTH: 2 UNITS: MG CODEINE PHOSPHATE STRENGTH: 10 UNITS: MG
CS FEDERAL SCHEDULE	Schedule V
INACTIVATION DATE	2005-10-14 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	CHLORPHENIRAMINE/CODEINE/PHENYLPROPANOLAMINE ELIXIR
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/CPM 2/PPA 18.75MG/5ML ELIX
VA PRODUCT IDENTIFIER	C0780
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4008120
EFFECTIVE DATE/TIME	2001-01-12 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE