APAP 250MG/DM 10MG/GG 100MG/PSEUDEFED 30MG CAP (9060) VA PRODUCT (50.68)

Name	Value
NAME	APAP 250MG/DM 10MG/GG 100MG/PSEUDEFED 30MG CAP
VA GENERIC NAME	ACETAMINOPHEN/DEXTROMETHORPHAN/GUAIFENESIN/PSEUDOEPHEDRINE
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	ACETAMINOPHEN STRENGTH: 250 UNITS: MG PSEUDOEPHEDRINE HYDROCHLORIDE STRENGTH: 30 UNITS: MG DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 10 UNITS: MG GUAIFENESIN STRENGTH: 100 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	3
NATIONAL FORMULARY NAME	ACETAMINOPHEN/DEXTROMETHORPHAN/GUAIFENESIN/PSEUDOEPHEDRINE CAP,ORAL
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	ACETAMINOPHEN250/DM10/GG100/PSEUDO30 CAP
VA PRODUCT IDENTIFIER	A1626
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4009502
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE