DEXTROMETHORPHAN 10MG/GUAIFENESIN 100MG/5ML SYRUP (4920) VA PRODUCT (50.68)

Name	Value
NAME	DEXTROMETHORPHAN 10MG/GUAIFENESIN 100MG/5ML SYRUP
VA GENERIC NAME	DEXTROMETHORPHAN/GUAIFENESIN
DOSAGE FORM	SYRUP
ACTIVE INGREDIENTS	ALCOHOL STRENGTH: 1.4 UNITS: % DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 10 UNITS: MG/5ML GUAIFENESIN STRENGTH: 100 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
INACTIVATION DATE	2023-01-17 00:00:00
DSS NUMBER	6
NATIONAL FORMULARY NAME	DEXTROMETHORPHAN/GUAIFENESIN SYRUP
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 10/GUAIFENESIN 100MG/5ML SYRUP
VA PRODUCT IDENTIFIER	D0055
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4005461
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2023-01-17 00:00:00 STATUS: INACTIVE