APAP 325MG/DM 10MG/GG 200MG/P-EPHRINE HCL 5MG/15ML LIQUID (26236) VA PRODUCT (50.68)

Name	Value
NAME	APAP 325MG/DM 10MG/GG 200MG/P-EPHRINE HCL 5MG/15ML LIQUID
VA GENERIC NAME	ACETAMINOPHEN/DEXTROMETHORPHAN/GUAIFENESIN/PHENYLEPHRINE
DOSAGE FORM	LIQUID,ORAL
ACTIVE INGREDIENTS	ACETAMINOPHEN STRENGTH: 325 UNITS: MG/15ML PHENYLEPHRINE STRENGTH: 5 UNITS: MG/15ML DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 10 UNITS: MG/15ML GUAIFENESIN STRENGTH: 200 UNITS: MG/15ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	ACETAMINOPHEN/DEXTROMETHORPHAN/GUAIFENESIN/PHENYLEPHRINE 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	APAP325/DM10/GG200/PHENYLEPH5MG/15ML LIQ
VA PRODUCT IDENTIFIER	A1845
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4035034
EFFECTIVE DATE/TIME	2015-11-17 00:00:00 STATUS: ACTIVE