DEXBROMPHENIRAMINE 2MG/PHENYEPHRINE 7.5MG/DM 15MG/5ML SOLN,ORAL (31560) VA PRODUCT (50.68)

Name	Value
NAME	DEXBROMPHENIRAMINE 2MG/PHENYEPHRINE 7.5MG/DM 15MG/5ML SOLN,ORAL
VA GENERIC NAME	DEXBROMPHENIRAMINE/DEXTROMETHORPHAN/PHENYLEPHRINE
DOSAGE FORM	SOLN,ORAL
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	DEXBROMPHENIRAMINE MALEATE STRENGTH: 2 UNITS: MG/5ML PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 7.5 UNITS: MG/5ML DEXTROMETHORPHAN HYDROBROMIDE STRENGTH: 15 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	DEXBROMPHENIRAMINE/DEXTROMETHORPHAN/PHENYLEPHRINE SOLN,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2021-11-18 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	DEXBROMPHEN 2/P-E 7.5/DM 15MG/5ML SOLN
VA PRODUCT IDENTIFIER	D1274
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4040967
EFFECTIVE DATE/TIME	2021-11-18 00:00:00 STATUS: ACTIVE