APAP 217MG/DM 6.7MG/GG 67MG/5ML LIQUID (9835) VA PRODUCT (50.68)

Name	Value
NAME	APAP 217MG/DM 6.7MG/GG 67MG/5ML LIQUID
VA GENERIC NAME	ACETAMINOPHEN/DEXTROMETHORPHAN/GUAIFENESIN
DOSAGE FORM	LIQUID
ACTIVE INGREDIENTS	ACETAMINOPHEN STRENGTH: 217 UNITS: MG/5ML MENTHOL SUGAR DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 6.7 UNITS: MG/5ML SACCHARIN GUAIFENESIN STRENGTH: 67 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	ACETAMINOPHEN/DEXTROMETHORPHAN/GUAIFENESIN 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	APAP 217/DM 6.7/GUAIFENESIN 67MG/5ML LIQ
VA PRODUCT IDENTIFIER	A0675
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4010236
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE