BROMPHENIRAMINE 2MG/DM 10MG/PHENYLEPHRINE 5MG/5ML LIQUID (24045)    VA PRODUCT (50.68)

Name Value
NAME BROMPHENIRAMINE 2MG/DM 10MG/PHENYLEPHRINE 5MG/5ML LIQUID
VA GENERIC NAME BROMPHENIRAMINE/DEXTROMETHORPHAN/PHENYLEPHRINE
DOSAGE FORM LIQUID,ORAL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME BROMPHENIRAMINE/DEXTROMETHORPHAN/PHENYLE 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 BROMPHEN 2/DM 10/PHENYLEP 5MG/5ML LIQUID
VA PRODUCT IDENTIFIER B0717
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4032571
EFFECTIVE DATE/TIME
  • 2013-07-22 00:00:00
    STATUS:   ACTIVE