APAP 325MG/DM 10MG/DOXYLAMINE 6.25MG/PHENYLEPHRINE 5MG TAB (28231) VA PRODUCT (50.68)

Name	Value
NAME	APAP 325MG/DM 10MG/DOXYLAMINE 6.25MG/PHENYLEPHRINE 5MG TAB
VA GENERIC NAME	ACETAMINOPHEN/DEXTROMETHORPHAN/DOXYLAMINE/PHENYLEPHRINE
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	ACETAMINOPHEN STRENGTH: 325 UNITS: MG DOXYLAMINE SUCCINATE STRENGTH: 6.25 UNITS: MG PHENYLEPHRINE STRENGTH: 5 UNITS: MG DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 10 UNITS: MG
NATIONAL FORMULARY NAME	ACETAMINOPHEN/DEXTROMETHORPHAN/DOXYLAMINE/PHENYLEPHRINE TAB
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2018-03-01 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	APAP 325/DM 10/DOXY 6.25/P-EPHR 5MG TAB
VA PRODUCT IDENTIFIER	A1965
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4037221
EFFECTIVE DATE/TIME	2018-01-17 00:00:00 STATUS: ACTIVE