DM 5MG/GG 100MG/PHENYLEPHRINE 2.5MG/5ML LIQUID (26807) VA PRODUCT (50.68)

Name	Value
NAME	DM 5MG/GG 100MG/PHENYLEPHRINE 2.5MG/5ML LIQUID
VA GENERIC NAME	DEXTROMETHORPHAN/GUAIFENESIN/PHENYLEPHRINE
DOSAGE FORM	LIQUID
ACTIVE INGREDIENTS	PHENYLEPHRINE STRENGTH: 2.5 UNITS: MG/5ML DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 5 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
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 5MG/GG 100MG/P-EPHR 2.5MG/5ML LIQUID
VA PRODUCT IDENTIFIER	D1123
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4035655
EFFECTIVE DATE/TIME	2016-04-29 00:00:00 STATUS: ACTIVE