GUAIFENESIN 100MG/PHENYLPROPANOLAMINE 12.5MG/5ML SYRUP (6294) VA PRODUCT (50.68)

Name	Value
NAME	GUAIFENESIN 100MG/PHENYLPROPANOLAMINE 12.5MG/5ML SYRUP
VA GENERIC NAME	GUAIFENESIN/PHENYLPROPANOLAMINE
DOSAGE FORM	SYRUP
ACTIVE INGREDIENTS	PHENYLPROPANOLAMINE HYDROCHLORIDE STRENGTH: 12.5 UNITS: MG/5ML GUAIFENESIN STRENGTH: 100 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2002-04-04 00:00:00
DSS NUMBER	9
NATIONAL FORMULARY NAME	GUAIFENESIN/PHENYLPROPANOLAMINE 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	GG 100/PHENYLPROPANOLAMIN 12.5MG/5ML LIQ
VA PRODUCT IDENTIFIER	G0082
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4006814
EFFECTIVE DATE/TIME	2002-04-04 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE