DM 17.5MG/GG 385MG/P-EPHRINE 10MG TAB (27143) VA PRODUCT (50.68)

Name	Value
NAME	DM 17.5MG/GG 385MG/P-EPHRINE 10MG TAB
VA GENERIC NAME	DEXTROMETHORPHAN/GUAIFENESIN/PHENYLEPHRINE
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	PHENYLEPHRINE STRENGTH: 10 UNITS: MG DEXTROMETHORPHAN STRENGTH: 17.5 UNITS: MG GUAIFENESIN STRENGTH: 385 UNITS: MG
NATIONAL FORMULARY NAME	DEXTROMETHORPHAN/GUAIFENESIN/PHENYLEPHRINE TAB
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 17.5MG/GG 385MG/P-EPHRINE 10MG TAB
VA PRODUCT IDENTIFIER	D1135
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4036024
EFFECTIVE DATE/TIME	2016-09-01 00:00:00 STATUS: ACTIVE