GUAIFENESIN 100MG/THEOPHYLLINE 125MG TAB (5074) VA PRODUCT (50.68)

Name	Value
NAME	GUAIFENESIN 100MG/THEOPHYLLINE 125MG TAB
VA GENERIC NAME	GUAIFENESIN/THEOPHYLLINE
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	THEOPHYLLINE STRENGTH: 125 UNITS: MG GUAIFENESIN STRENGTH: 100 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-20 00:00:00
DSS NUMBER	7
NATIONAL FORMULARY NAME	GUAIFENESIN/THEOPHYLLINE TAB
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	GUAIFENESIN 100/THEOPHYLLINE 125MG TAB
VA PRODUCT IDENTIFIER	G0088
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4005615
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-20 00:00:00 STATUS: INACTIVE