DM 15MG/DOXYLAMINE 3.75MG/GG 100MG SYRUP (7050) VA PRODUCT (50.68)

Name	Value
NAME	DM 15MG/DOXYLAMINE 3.75MG/GG 100MG SYRUP
VA GENERIC NAME	DEXTROMETHORPHAN/DOXYLAMINE/GUAIFENESIN
DOSAGE FORM	SYRUP
ACTIVE INGREDIENTS	DOXYLAMINE SUCCINATE STRENGTH: 3.75 UNITS: MG DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 15 UNITS: MG GUAIFENESIN STRENGTH: 100 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-28 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	DEXTROMETHORPHAN/DOXYLAMINE/GUAIFENESIN 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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4007560
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-28 00:00:00 STATUS: INACTIVE