GUAIFENESIN 400MG/PHENYLPROPANOLAMINE 75MG CAP,SA (6287) VA PRODUCT (50.68)

Name	Value
NAME	GUAIFENESIN 400MG/PHENYLPROPANOLAMINE 75MG CAP,SA
VA GENERIC NAME	GUAIFENESIN/PHENYLPROPANOLAMINE
DOSAGE FORM	CAP,SA
ACTIVE INGREDIENTS	PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 75 UNITS: MG GUAIFENESIN STRENGTH: 400 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2002-04-04 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	GUAIFENESIN/PHENYLPROPANOLAMINE CAP,SA
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 400/PHENYLPROPANOLAMINE 75MG SA CAP
VA PRODUCT IDENTIFIER	G0109
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4006807
EFFECTIVE DATE/TIME	2002-04-04 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE