DEXTROMETHORPHAN 20MG/GUAIFENESIN 200MG/5ML ELIXIR (4933) VA PRODUCT (50.68)

Name	Value
NAME	DEXTROMETHORPHAN 20MG/GUAIFENESIN 200MG/5ML ELIXIR
VA GENERIC NAME	DEXTROMETHORPHAN/GUAIFENESIN
DOSAGE FORM	ELIXIR
ACTIVE INGREDIENTS	DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 20 UNITS: MG/5ML GUAIFENESIN STRENGTH: 200 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2016-09-29 00:00:00
DSS NUMBER	20
NATIONAL FORMULARY NAME	DEXTROMETHORPHAN/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
VA PRINT NAME	DM 20/GUAIFENESIN 200MG/5ML ELIXIR
VA PRODUCT IDENTIFIER	D0359
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4005474
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE