CODEINE 10MG/P-EPHRINE 5MG/PYRILAMINE 8.33MG/5ML SYRUP (7859)    VA PRODUCT (50.68)

Name Value
NAME CODEINE 10MG/P-EPHRINE 5MG/PYRILAMINE 8.33MG/5ML SYRUP
VA GENERIC NAME CODEINE/PHENYLEPHRINE/PYRILAMINE
DOSAGE FORM SYRUP
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Schedule V
INACTIVATION DATE 2010-06-14 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME CODEINE/PHENYLEPHRINE/PYRILAMINE 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 4008337
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2010-06-14 00:00:00
    STATUS:   INACTIVE