DEXTROMETHORPHAN 15MG/GUAIFENESIN 125MG/5ML (SF&AF) LIQUID,ORAL (23721) VA PRODUCT (50.68)

Name	Value
NAME	DEXTROMETHORPHAN 15MG/GUAIFENESIN 125MG/5ML (SF&AF) LIQUID,ORAL
VA GENERIC NAME	DEXTROMETHORPHAN/GUAIFENESIN
DOSAGE FORM	LIQUID,ORAL
ACTIVE INGREDIENTS	DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 15 UNITS: MG/5ML GUAIFENESIN STRENGTH: 125 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
INACTIVATION DATE	2020-01-15 00:00:00
NATIONAL FORMULARY NAME	DEXTROMETHORPHAN/GUAIFENESIN 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
VA PRINT NAME	DM 15/GUAIFENESIN 125MG/5ML (SF/AF) LIQ
VA PRODUCT IDENTIFIER	D0956
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4032209
EFFECTIVE DATE/TIME	2013-03-13 00:00:00 STATUS: ACTIVE 2020-01-15 00:00:00 STATUS: INACTIVE