DEXTROMETHORPHAN 10MG/GUAIFENESIN 200MG/5ML (ALC-F) LIQUID (24588)    VA PRODUCT (50.68)

Name Value
NAME DEXTROMETHORPHAN 10MG/GUAIFENESIN 200MG/5ML (ALC-F) LIQUID
VA GENERIC NAME DEXTROMETHORPHAN/GUAIFENESIN
DOSAGE FORM LIQUID,ORAL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
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 10/GUAIFENESIN 200MG/5ML (ALC-F) LIQ
VA PRODUCT IDENTIFIER D1012
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4033186
EFFECTIVE DATE/TIME
  • 2014-03-28 00:00:00
    STATUS:   ACTIVE