DEXTROMETHORPHAN HBR 15MG/DOXYLAMINE 6.25MG/15ML LIQUID (23005)    VA PRODUCT (50.68)

Name Value
NAME DEXTROMETHORPHAN HBR 15MG/DOXYLAMINE 6.25MG/15ML LIQUID
VA GENERIC NAME DEXTROMETHORPHAN/DOXYLAMINE
DOSAGE FORM LIQUID,ORAL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME DEXTROMETHORPHAN/DOXYLAMINE LIQUID,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 DM 15MG/DOXYLAMINE 6.25MG/15ML LIQUID
VA PRODUCT IDENTIFIER D0939
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4031389
EFFECTIVE DATE/TIME
  • 2012-04-06 00:00:00
    STATUS:   ACTIVE