DEXTROMETHORPHAN HBR 30MG/DOXYLAMINE 12.5MG/10ML LIQUID (26325) VA PRODUCT (50.68)

Name	Value
NAME	DEXTROMETHORPHAN HBR 30MG/DOXYLAMINE 12.5MG/10ML LIQUID
VA GENERIC NAME	DEXTROMETHORPHAN/DOXYLAMINE
DOSAGE FORM	LIQUID,ORAL
ACTIVE INGREDIENTS	DOXYLAMINE STRENGTH: 12.5 UNITS: MG/10ML DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 30 UNITS: MG/10ML
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 30MG/DOXYLAMINE 12.5MG/10ML LIQUID
VA PRODUCT IDENTIFIER	D1115
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4035131
EFFECTIVE DATE/TIME	2015-11-27 00:00:00 STATUS: ACTIVE