DEXTROMETHORPHAN HBR 10MG/GUAIFENESIN 85MG/5ML (SF & AF) SYRUP (4929) VA PRODUCT (50.68)

Name	Value
NAME	DEXTROMETHORPHAN HBR 10MG/GUAIFENESIN 85MG/5ML (SF & AF) SYRUP
VA GENERIC NAME	DEXTROMETHORPHAN/GUAIFENESIN
DOSAGE FORM	SYRUP
ACTIVE INGREDIENTS	DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 10 UNITS: MG/5ML GUAIFENESIN STRENGTH: 85 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2009-11-17 00:00:00
DSS NUMBER	15
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 85MG/5ML (ALC-F/SF)SYR
VA PRODUCT IDENTIFIER	D0280
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4005470
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2009-11-17 00:00:00 STATUS: INACTIVE