GUAIFENESIN 150MG/OXTRIPHYLLINE 300MG/15ML ELIXIR (5167) VA PRODUCT (50.68)

Name	Value
NAME	GUAIFENESIN 150MG/OXTRIPHYLLINE 300MG/15ML ELIXIR
VA GENERIC NAME	GUAIFENESIN/OXTRIPHYLLINE
DOSAGE FORM	ELIXIR
ACTIVE INGREDIENTS	OXTRIPHYLLINE STRENGTH: 300 UNITS: 15ML ALCOHOL STRENGTH: 20 UNITS: % GUAIFENESIN STRENGTH: 150 UNITS: MG/15ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2003-07-31 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	GUAIFENESIN/OXTRIPHYLLINE 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	GG 150/OXTRIPHYLLINE 300MG/15ML ELIXIR
VA PRODUCT IDENTIFIER	G0093
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4005708
EFFECTIVE DATE/TIME	2003-07-31 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE