ACETAMINOPHEN 325MG/DM 10MG/DIPHENHYDRAMINE 12.5MG/5ML LIQUID (25327) VA PRODUCT (50.68)

Name	Value
NAME	ACETAMINOPHEN 325MG/DM 10MG/DIPHENHYDRAMINE 12.5MG/5ML LIQUID
VA GENERIC NAME	ACETAMINOPHEN/DEXTROMETHORPHAN/DIPHENHYDRAMINE
DOSAGE FORM	LIQUID,ORAL
ACTIVE INGREDIENTS	ACETAMINOPHEN STRENGTH: 325 UNITS: MG/15ML DIPHENHYDRAMINE HYDROCHLORIDE STRENGTH: 12.5 UNITS: MG/5ML DEXTROMETHORPHAN STRENGTH: 10 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	ACETAMINOPHEN/DEXTROMETHORPHAN/DIPHENHYDRAMINE 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	ACETAMINOPH 325/DM 10/DIPH12.5MG/5ML LIQ
VA PRODUCT IDENTIFIER	A1781
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4034031
EFFECTIVE DATE/TIME	2015-01-06 00:00:00 STATUS: ACTIVE