BROMPHENIRAMINE 4MG/DM 20MG/PHENYLEPHRINE 10MG/5ML LIQUID (24412) VA PRODUCT (50.68)

Name	Value
NAME	BROMPHENIRAMINE 4MG/DM 20MG/PHENYLEPHRINE 10MG/5ML LIQUID
VA GENERIC NAME	BROMPHENIRAMINE/DEXTROMETHORPHAN/PHENYLEPHRINE
DOSAGE FORM	LIQUID,ORAL
ACTIVE INGREDIENTS	BROMPHENIRAMINE STRENGTH: 4 UNITS: MG/5ML PHENYLEPHRINE STRENGTH: 10 UNITS: MG/5ML DEXTROMETHORPHAN STRENGTH: 20 UNITS: MG/5ML
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 4/DM 20/PHENYLEPH 10MG/5ML LIQ
VA PRODUCT IDENTIFIER	B0730
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4032985
EFFECTIVE DATE/TIME	2014-01-17 00:00:00 STATUS: ACTIVE