ACETAMINOPHEN 500MG/DIPHENHYDRAMINE HCL 25MG CAP,ORAL (26586)    VA PRODUCT (50.68)

Name Value
NAME ACETAMINOPHEN 500MG/DIPHENHYDRAMINE HCL 25MG CAP,ORAL
VA GENERIC NAME ACETAMINOPHEN/DIPHENHYDRAMINE
DOSAGE FORM CAP,ORAL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2016-03-15 00:00:00
NATIONAL FORMULARY NAME ACETAMINOPHEN/DIPHENHYDRAMINE CAP,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 ACETAMINOPHEN500/DIPHENHYDRAMINE25MG CAP
VA PRODUCT IDENTIFIER A1875
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4035420
EFFECTIVE DATE/TIME
  • 2016-02-18 00:00:00
    STATUS:   ACTIVE