BROMPHENIRAMINE 4MG/DM 15MG/PHENYLEPHRINE 7.5MG/5ML LIQUID (26745) VA PRODUCT (50.68)

Name	Value
NAME	BROMPHENIRAMINE 4MG/DM 15MG/PHENYLEPHRINE 7.5MG/5ML LIQUID
VA GENERIC NAME	BROMPHENIRAMINE/DEXTROMETHORPHAN/PHENYLEPHRINE
DOSAGE FORM	LIQUID,ORAL
ACTIVE INGREDIENTS	BROMPHENIRAMINE STRENGTH: 4 UNITS: MG/5ML PHENYLEPHRINE STRENGTH: 7.5 UNITS: MG/5ML DEXTROMETHORPHAN STRENGTH: 15 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	BROMPHENIRAMINE/DEXTROMETHORPHAN/PHENYLEPHRINE 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 15/PHENYLEPH 7.5MG/5ML LIQ
VA PRODUCT IDENTIFIER	B0810
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4035583
EFFECTIVE DATE/TIME	2016-03-31 00:00:00 STATUS: ACTIVE