DM 10MG/GG 100MG/PHENYLEPHRINE 5MG/5ML (SF) LIQUID (25656) VA PRODUCT (50.68)

Name	Value
NAME	DM 10MG/GG 100MG/PHENYLEPHRINE 5MG/5ML (SF) LIQUID
VA GENERIC NAME	DEXTROMETHORPHAN/GUAIFENESIN/PHENYLEPHRINE
DOSAGE FORM	LIQUID(SF)
ACTIVE INGREDIENTS	PHENYLEPHRINE STRENGTH: 5 UNITS: MG/5ML DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 10 UNITS: MG/5ML GUAIFENESIN STRENGTH: 100 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	DEXTROMETHORPHAN/GUAIFENESIN/PHENYLEPHRINE LIQUID(SF)
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	No Possible Dosages
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 10MG/GG 100MG/P-EPHR 5MG/5ML (SF) LIQ
VA PRODUCT IDENTIFIER	D1092
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4034400
EFFECTIVE DATE/TIME	2015-04-23 00:00:00 STATUS: ACTIVE