DM 5MG/GG 75MG/PHENYLEPHRINE 2.5MG/5ML (AF/SF) LIQUID (27582) VA PRODUCT (50.68)

Name	Value
NAME	DM 5MG/GG 75MG/PHENYLEPHRINE 2.5MG/5ML (AF/SF) 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: 75 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: 2017-05-01 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	DM 5/GG 75/P-EPHR 2.5MG/5ML (AF/SF) LIQ
VA PRODUCT IDENTIFIER	D1152
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4036502
EFFECTIVE DATE/TIME	2017-03-22 00:00:00 STATUS: ACTIVE