| NAME |
DEXCHLORPHENIRAMINE MALEATE 2MG/5ML SOLN,ORAL |
| VA GENERIC NAME |
DEXCHLORPHENIRAMINE |
| DOSAGE FORM |
SOLN,ORAL |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
2 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/5ML |
| NATIONAL FORMULARY NAME |
DEXCHLORPHENIRAMINE SOLN,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2018-10-25 00:00:00
- COPAY END DATE: 2019-01-14 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2019-01-15 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DEXCHLORPHENIRAMINE 2MG/5ML ORAL SOLN |
| VA PRODUCT IDENTIFIER |
D1199 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037938 |
| EFFECTIVE DATE/TIME |
-
- 2018-10-25 00:00:00
- STATUS: ACTIVE
|
