DYPHYLLINE 100MG/GUAIFENESIN 100MG/15ML ELIXIR (4266) VA PRODUCT (50.68)

Name	Value
NAME	DYPHYLLINE 100MG/GUAIFENESIN 100MG/15ML ELIXIR
VA GENERIC NAME	DYPHYLLINE/GUAIFENESIN
DOSAGE FORM	ELIXIR
ACTIVE INGREDIENTS	DYPHYLLINE STRENGTH: 100 UNITS: MG/15ML ALCOHOL GUAIFENESIN STRENGTH: 100 UNITS: MG/15ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2016-01-26 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	DYPHYLLINE/GUAIFENESIN ELIXIR
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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4004818
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE