| NAME |
DIPHENHYDRAMINE HCL 25MG TAB,CHEWABLE |
| VA GENERIC NAME |
DIPHENHYDRAMINE |
| DOSAGE FORM |
TAB,CHEWABLE |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
25 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
DIPHENHYDRAMINE TAB,CHEWABLE |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
1x Possible Dosage |
| PACKAGE |
Both Inpatient and Outpatient |
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2023-01-26 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DIPHENHYDRAMINE 25MG CHEW TAB |
| VA PRODUCT IDENTIFIER |
D1304 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
TAB |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4041987 |
| EFFECTIVE DATE/TIME |
-
- 2023-01-26 00:00:00
- STATUS: ACTIVE
|
