DM 10MG/GG 100MG/PSEUDEFED 30MG/5ML SYRUP (7013) VA PRODUCT (50.68)

Name	Value
NAME	DM 10MG/GG 100MG/PSEUDEFED 30MG/5ML SYRUP
VA GENERIC NAME	DEXTROMETHORPHAN/GUAIFENESIN/PSEUDOEPHEDRINE
DOSAGE FORM	LIQUID
ACTIVE INGREDIENTS	PSEUDOEPHEDRINE HYDROCHLORIDE STRENGTH: 30 UNITS: MG/5ML DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 10 UNITS: MG/5ML GUAIFENESIN STRENGTH: 100 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
INACTIVATION DATE	2004-11-18 00:00:00
DSS NUMBER	10
NATIONAL FORMULARY NAME	DEXTROMETHORPHAN/GUAIFENESIN/PSEUDOEPHEDRINE LIQUID
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 10/GG 100/PSEUDO 30MG/5ML LIQUID
VA PRODUCT IDENTIFIER	D0304
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	NO
VUID	4007525
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2005-12-08 00:00:00 STATUS: ACTIVE 2004-11-18 00:00:00 STATUS: INACTIVE