DM 10MG/P-EPHRINE 5MG/PYRILAMINE 8.3MG/5ML SYRUP (7858) VA PRODUCT (50.68)

Name	Value
NAME	DM 10MG/P-EPHRINE 5MG/PYRILAMINE 8.3MG/5ML SYRUP
VA GENERIC NAME	DEXTROMETHORPHAN/PHENYLEPHRINE/PYRILAMINE
DOSAGE FORM	SYRUP
ACTIVE INGREDIENTS	ALCOHOL STRENGTH: 4 UNITS: % PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG/5ML DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 10 UNITS: MG/5ML PYRILAMINE MALEATE STRENGTH: 8.33 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	1
NATIONAL FORMULARY NAME	DEXTROMETHORPHAN/PHENYLEPHRINE/PYRILAMINE 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	DM10/P-EPHED5/PYRILAMINE 8.3MG/5ML SYRUP
VA PRODUCT IDENTIFIER	D0833
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4008336
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE