CODEINE 10MG/P-PROPANOL 5MG/PROMETH 6.25MG/5ML SYRUP (7814) VA PRODUCT (50.68)

Name	Value
NAME	CODEINE 10MG/P-PROPANOL 5MG/PROMETH 6.25MG/5ML SYRUP
VA GENERIC NAME	CODEINE/PHENYLPROPANOLAMINE/PROMETHAZINE
DOSAGE FORM	SYRUP
HAZARDOUS TO DISPOSE	NO
DOT SHIPPING CODE
ACTIVE INGREDIENTS	PROMETHAZINE HYDROCHLORIDE STRENGTH: 6.25 UNITS: MG/5ML PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG/5ML CODEINE PHOSPHATE STRENGTH: 10 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Schedule V
INACTIVATION DATE	2005-10-14 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	CODEINE/PHENYLPROPANOLAMINE/PROMETHAZINE 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	4008292
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2005-10-14 00:00:00 STATUS: INACTIVE