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Good Neighbor Pharmacy Cough DM ER dextromethorphan polistirex 30 mg/5mL Suspension — NDC 46122-0141-25 package photo

Good Neighbor Pharmacy Cough DM ER dextromethorphan polistirex 30 mg/5mL Suspension

by Amerisource Bergen · 1 BOTTLE in 1 CARTON (46122-141-25) / 148 mL in 1 BOTTLE
NDC 46122-0141-25
🏷️ FDA NDC (as labeled) 46122-141-25 billing pads the product segment with a zero
This package
Contains148 mL in 1 bottle Cost per mL$0.0526 NADAC Per package$7.78 / 148 ml Pack sizes2 compare ↓
Also priced by: Medicaid pays $0.1067/unit — full pricing hub ↓
Also comes in: 89 mL 46122-0141-21
OTC Generic On market Non-controlled
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

This page is curated, coded, and maintained by

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

🆔 Identity & classification

FDA NDC (as labeled) 46122-141-25
Product NDC 46122-141
11-digit billing NDC 46122014125
NCPDP billing unit ML — per mL (volume)
RxCUI 1373045
UNII 9D2RTI9KYH
Application # ANDA091135
SPL Set ID 4b23739b-5fae-4348-a387-c23dcde90b8b
Established class (EPC) Sigma-1 Agonist; Uncompetitive N-methyl-D-aspartate Receptor Antagonist
Mechanism of action Sigma-1 Receptor Agonists; Uncompetitive NMDA Receptor Antagonists
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2012-08-30
Route ORAL
Dosage form SUSPENSION
Substance DEXTROMETHORPHAN HYDROBROMIDE
GPI-14 4310203060G110
GPI class GNP Cough DM ER
GCN Seq No 004630
GCN 17802
HICL code 010295
Ingredient (HICL) Dextromethorphan Polistirex
HIC1 code H
Therapeutic class — broad (HIC1) Nervous System (Except Autonomic)
HIC2 code H6
Therapeutic class — intermediate (HIC2) Drugs Acting Principally On The Midbrain
HIC3 code H6C
Therapeutic class — specific (HIC3) Antitussives, Non-Opioid
AHFS code 48:08.00.00
AHFS class Antitussives
FDB label name COUGH DM ER 30 MG/5 ML SUSP
FDB brand name Cough Dm Er
Legend status O — Over-the-counter (OTC) drug or device
Why two NDCs? The FDA registers this code as 46122-141-25 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 46122-0141-25. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Uncompetitive N-methyl-D-aspartate Receptor Antagonist class.

Pharmacologic class Uncompetitive N-methyl-D-aspartate Receptor Antagonist, Sigma-1 Agonist
Drug family (ATC) Other antidepressants, Opium alkaloids and derivatives
How it works Uncompetitive NMDA Receptor Antagonists, Sigma-1 Receptor Agonists
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerAmerisource Bergen
Application holderTRIS PHARMA INC
FDA applicationANDA091135 (ANDA)
Labeler code46122
First marketedAug 2012
Product typeHuman Otc Drug
Portfolio206 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name COUGH DM ER 30 MG/5 ML SUSP Ingredient Dextromethorphan Polistirex
📗 Our plain-language guide HelloPharmacist
  • It won't necessarily silence your cough entirely, but it does temporarily suppress the cough reflex and reduce how intense and frequent your cough is. It can also help reduce that...
  • What exactly does dextromethorphan do — will it stop my cough completely?
  • It depends on your child's age and the specific product. Most dextromethorphan products should not be given to children under 4 years old without a doctor's guidance. Some products...
  • This is a really important question. If your antidepressant is an MAOI (monoamine oxidase inhibitor), you absolutely cannot take dextromethorphan — not while you're on it, and not...
📖 Read our full Dextromethorphan guide →

Supplement & herbal interactions

🌿 Drug–supplement interaction checker →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

💊 What it looks like

Color Orange
FlavorOrange
One label can cover several strengths, so colors may be combined — always confirm a loose pill against the dispensed prescription label or a pharmacist.
Where does this data come from?
Physical description (imprint, shape, color, scoring, coating) from this product’s FDA Structured Product Labeling (SPL), mirrored from DailyMed / openFDA.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII 2S42T2808B
    A synthetic red dye used as a colorant to give the medicine its red color. It helps make pills or liquids visually distinct and easier to identify.
  • UNII 35SW5USQ3G
    A synthetic yellow dye used to color medicines. It helps make tablets, capsules, and liquids visually distinct so patients can easily identify their medication.
  • UNII PDC6A3C0OX
    Glycerin is a clear, thick liquid derived from plant oils or fats. It acts as a humectant to retain moisture, a sweetener, and a solvent in medications.
  • UNII XY6UN3QB6S
    A sweetener made from corn starch that contains fructose and glucose. It sweetens the medicine to improve taste and may help preserve the product.
  • UNII A2I8C7HI9T
    Methylparaben is a preservative derived from benzoic acid that prevents growth of bacteria, fungi, and mold in medicines. It extends the product's shelf life and maintains safety during storage.
  • UNII 5H9W9GTW27
    A synthetic polymer derived from styrene that binds and holds active ingredients together in solid forms. It's used as a binder and tablet/capsule filler to give the medicine its shape and help it stay intact.
  • UNII 6OZP39ZG8H
    Polysorbate 80 is a synthetic emulsifier derived from sorbitol and oleic acid. It helps mix oil and water-based ingredients together in medications and improves how the product disperses in the body.
  • UNII 32K497ZK2U
    Polyvinyl acetate is a synthetic plastic polymer derived from vinyl acetate. It acts as a binder and film-forming agent in medicines, helping to hold ingredients together and create protective coatings on tablets or capsules.
  • UNII FZ989GH94E
    Povidone is a synthetic polymer made from a plastic-like material. It acts as a binder to hold tablet ingredients together and as a disintegrant to help the tablet break apart in your stomach so the medicine can be absorbed.
  • UNII Z8IX2SC1OH
    Propylparaben is a chemical preservative used to prevent bacterial and fungal growth in medicines and personal care products. It helps extend shelf life and maintain product safety during storage.
  • UNII 4VON5FNS3C
    Sodium metabisulfite is a preservative derived from sulfur compounds. It prevents microbial growth and oxidation in medicines, helping extend shelf life and maintain product stability.
  • UNII 1699G8679Z
    A synthetic polymer that acts as a binder and helps hold tablet or capsule ingredients together. It may also be used to improve how the medicine dissolves or is absorbed in the digestive system.
  • UNII C151H8M554
    A natural sugar derived from sugar cane or sugar beets. It's used as a sweetener, filler, and binder to improve taste, add bulk, and help hold tablet or capsule ingredients together.
  • UNII W4888I119H
    Tartaric acid is a natural organic acid found in grapes and tamarinds. In medicines, it works as a buffer to control acidity, an antioxidant to prevent spoilage, and sometimes a flavoring or binding agent.
  • UNII 2944357O2O
    A natural gum derived from the tragacanth shrub, used as a thickener, stabilizer, and binder in medicines. It helps create the right consistency and keeps ingredients evenly mixed throughout the product.
  • UNII XHX3C3X673
    Triacetin is a clear, oily liquid made from glycerin and acetic acid. It works as a plasticizer and solvent in medicines, helping soften coatings and improve how liquids mix together in formulations.
  • UNII 059QF0KO0R
    Water is a liquid solvent that dissolves and mixes ingredients together in liquid medicines, syrups, and injections. It helps distribute the active drug evenly throughout the product.
  • UNII TTV12P4NEE
    Xanthan gum is a thickening and stabilizing ingredient made from fermented corn or other sugars. It's added to medicines to improve texture, prevent separation of liquids and solids, and help the product stay consistent.

18 inactive ingredients listed in the exact product block matched to this NDC.

The official label also statesD&C Red #30 aluminum lake, D&C Yellow #10 aluminum lake, glycerin, high fructose corn syrup, methylparaben, natural and artificial orange flavor, polysorbate 80, polyvinyl acetate, povidone, propylparaben, purified water, sodium metabisulfite, sodium polystyrene sulfonate, sucrose, tartaric acid, tragacanth gum, triacetin, xanthan gum

Label-section wording can be broader than the structured product block and may mention additional formulation ingredients.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMed — ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer mLPer package
Retail pharmacies payNADAC · weekly $0.053 $7.78 / 148 ml
Medicaid paysCMS SDUD · 12 mo $0.1067 $15.79 / 148 ml
Medicare drug plans payPart D · quarterly No Part D plan price is available for this NDC in our data.
NADAC price history (per mL) — tap or hover for the price & month
Dec 2021 Oct 2022 Feb 2026 Sep 2026 $0.053 $0.046
▲ Up 2% over the last 22 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Good Neighbor Pharmacy Cough DM ER 30 mg/5mLthis 46122-0141-25 Amerisource 1 bottle $0.053 — Availability likely —
Good Sense Cough DM 30 mg/5mL 00113-0958-21 L. 1 bottle $0.066 — Availability likely +26%
cough dm 30 mg/5mL 00904-6312-56 Major 1 bottle $0.066 — Availability likely +26%
dextromethorphan polistirex extended release 30 mg/5mL 45802-0433-21 Padagis 1 bottle $0.066 — Availability likely +26%
Leader Cough DM 30 mg/5mL 70000-0187-01 Cardinal 1 bottle $0.066 — Availability likely +26%
leader childrens cough dm 30 mg/5mL 70000-0195-01 Cardinal 1 bottle $0.066 — Availability likely +26%
Leader Cough DM 30 mg/5mL 70000-0302-01 Cardinal 1 bottle $0.066 — Availability likely +26%
foster and thrive 12 hour cough relief 30 mg/5mL 70677-1025-01 Strategic 1 bottle $0.066 — Availability likely +26%
foster and thrive 12 hour cough relief 30 mg/5mL 70677-1026-01 Strategic 1 bottle $0.066 — Availability likely +26%
Delsym (Dextromethorphan) 30 mg/5mL 63824-0173-63 Reckitt 1 bottle $0.102 — FDA listed +93%
Delsym (Dextromethorphan) 30 mg/5mL 63824-0177-63 Reckitt 1 bottle $0.102 — FDA listed +93%
Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8655-10 Haleon 1 bottle — — FDA listed —
Childrens Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8725-10 Haleon 1 bottle — — FDA listed —
Childrens Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8726-10 Haleon 1 bottle — — FDA listed —
Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8753-03 Haleon 1 bottle — — FDA listed —
Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8754-15 Haleon 1 bottle — — FDA listed —
Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8755-15 Haleon 1 bottle — — FDA listed —
good sense cough dm 30 mg/5mL 00113-0384-21 L. 1 bottle — — Discontinued —
Cough DM 30 mg/5mL 00363-0384-21 Walgreen 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 00363-0494-21 Walgreen 1 bottle — — Discontinued —
childrens cough dm 30 mg/5mL 00363-0899-21 Walgreen 1 bottle — — FDA listed —
up and up 12 hour cough relief 30 mg/5mL 11673-0114-28 Target 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 11822-0384-01 Rite 1 bottle — — Discontinued —
Cough DM 30 mg/5mL 11822-0494-01 Rite 1 bottle — — Discontinued —
Cough DM 30 mg/5mL 11822-0958-01 Rite 1 bottle — — Discontinued —
cough dm 30 mg/5mL 17856-6312-01 ATLANTIC 5 ml — — FDA listed —
signature care 12 hour cough relief 30 mg/5mL 21130-0012-21 Safeway 1 bottle — — FDA listed —
Signature Care Cough Relief 30 mg/5mL 21130-0520-21 Safeway 1 bottle — — FDA listed —
Cough Dm 30 mg/5mL 21130-0538-21 Safeway 1 bottle — — FDA listed —
signature care childrens 12 hour cough relief 30 mg/5mL 21130-0890-21 Safeway 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 30142-0384-21 Kroger 1 bottle — — FDA listed —
cough dm 30 mg/5mL 30142-0494-21 Kroger 1 bottle — — FDA listed —
TopCare Cough DM 30 mg/5mL 36800-0494-21 Topco 1 bottle — — FDA listed —
Topcare Cough DM 30 mg/5mL 36800-0552-21 Topco 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 37808-0384-21 H 1 bottle — — FDA listed —
equaline cough dm 30 mg/5mL 41163-0384-21 United 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 41250-0384-28 Meijer 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 41250-0494-28 Meijer 1 bottle — — FDA listed —
cough dm childrens 30 mg/5mL 41250-0899-28 Meijer 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 41250-0958-28 Meijer 1 bottle — — FDA listed —
CareOne Cough DM 30 mg/5mL 41520-0384-21 American 1 bottle — — FDA listed —
CareOne Cough DM 30 mg/5mL 41520-0958-21 American 1 bottle — — FDA listed —
cough dm 30 mg/5mL 42507-0384-21 HyVee 1 bottle — — FDA listed —
cough dm 30 mg/5mL 42507-0494-21 HyVee 1 bottle — — FDA listed —
Equate Cough DM 30 mg/5mL 49035-0384-21 Wal-Mart 1 bottle — — FDA listed —
equate cough dm 30 mg/5mL 49035-0899-28 Wal-Mart 1 bottle — — FDA listed —
Delsym 30 mg/5mL 50090-0224-00 A-S 1 bottle — — FDA listed —
12 Hr Relief Cough Dm 30 mg/5mL 51316-0263-21 CVS 1 bottle — — FDA listed —
Childrens 12 Hr Cough Relief 30 mg/5mL 51316-0429-28 CVS 1 bottle — — FDA listed —
DG Health Cough DM 30 mg/5mL 55910-0384-21 Dolgencorp 1 bottle — — FDA listed —
DG Health Cough DM 30 mg/5mL 55910-0958-21 Dolgencorp, 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 56062-0384-21 Publix 1 bottle — — FDA listed —
Dextromethorphan Polistirex 30 mg/5mL 58602-0610-05 Aurohealth 1 bottle — — FDA listed —
Dextromethorphan Polistirex 30 mg/5mL 58602-0611-05 Aurohealth 1 bottle — — FDA listed —
Dextromethorphan Polistirex 30 mg/5mL 58602-0617-05 Aurohealth 1 bottle — — FDA listed —
Dextromethorphan Polistirex 30 mg/5mL 58602-0618-05 Aurohealth 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 59779-0384-21 CVS 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 59779-0709-21 CVS 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 59779-0958-21 CVS 1 bottle — — FDA listed —
Delsym 30 mg/5mL 63824-0171-22 Reckitt 1 cello — — FDA listed —
Delsym 30 mg/5mL 63824-0175-22 Reckitt 1 cello — — FDA listed —
Dextromethorphan Polistirex Extended-Release 30 mg/5mL 65162-0700-76 Amneal 1 bottle — — FDA listed —
Dextromethorphan Polistirex Extended-Release 30 mg/5mL 65162-0799-76 Amneal 1 bottle — — FDA listed —
dextromethorphan polistirex extended release 30 mg/5mL 72162-2281-02 Bryant 1 bottle — — FDA listed —
basic care cough dm 30 mg/5mL 72288-0384-28 Amazon.com 1 bottle — — FDA listed —
basic care cough dm 30 mg/5mL 72288-0494-28 Amazon.com 1 bottle — — FDA listed —
basic care childrens cough dm 30 mg/5mL 72288-0899-28 Amazon.com 1 bottle — — FDA listed —
basic care childrens cough dm 30 mg/5mL 72288-0958-28 Amazon.com 1 bottle — — FDA listed —
cough dm 30 mg/5mL 72288-0652-28 Amazon.com 1 bottle — — FDA listed —
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

⏳ Availability & generic status

🏛️
2012
On the market since
Aug 2012
📍
2026
Currently FDA-listed
14 years listed
🔓
·
Generic on the market
this product is a generic
✅This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🗺️ Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for 46122-0141-25, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q4 2025 · 4 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
1.1K
Units reimbursed last 4 qtrs
159.7K
Gross reimbursed last 4 qtrs
$17K
Avg / prescription
$15.25
Avg / unit
$0.1067
Latest quarter Q4 2025
273Rx
Medicaid pays / mL
$0.1067
gross reimbursed
vs
NADAC / mL
$0.0526
acquisition cost
=
Spread
+$0.0541
+103% vs cost
What Medicaid paid per mL (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care ⓘ
42% FFS 58% MCO
Fee-for-service · 469 Rx Managed care · 648 Rx
State Medicaid map
Alaska: no data reported AK Maine: no data reported ME Washington: no data reported WA Idaho: no data reported ID Montana: no data reported MT North Dakota: no data reported ND Minnesota: no data reported MN Wisconsin: no data reported WI Michigan: no data reported MI New York: 43,520 units · 222 per 100k residents NY Vermont: no data reported VT New Hampshire: no data reported NH Oregon: no data reported OR Nevada: no data reported NV Wyoming: no data reported WY South Dakota: no data reported SD Iowa: no data reported IA Illinois: no data reported IL Indiana: 1,215 units · 17.7 per 100k residents IN Ohio: 9,323 units · 79.1 per 100k residents OH Pennsylvania: 4,501 units · 34.7 per 100k residents PA New Jersey: 17,434 units · 188 per 100k residents NJ Massachusetts: no data reported MA California: no data reported CA Utah: no data reported UT Colorado: no data reported CO Nebraska: no data reported NE Missouri: 17,064 units · 275 per 100k residents MO Kentucky: 30,016 units · 663 per 100k residents KY West Virginia: no data reported WV Virginia: 4,193 units · 48.1 per 100k residents VA Maryland: no data reported MD Connecticut: no data reported CT Rhode Island: no data reported RI Arizona: 2,072 units · 27.9 per 100k residents AZ New Mexico: no data reported NM Kansas: no data reported KS Arkansas: no data reported AR Tennessee: no data reported TN North Carolina: no data reported NC South Carolina: no data reported SC Delaware: no data reported DE Oklahoma: no data reported OK Louisiana: no data reported LA Mississippi: 7,563 units · 257 per 100k residents MS Alabama: no data reported AL Georgia: 22,771 units · 206 per 100k residents GA D.C.: no data reported DC Hawaii: no data reported HI Texas: no data reported TX Florida: no data reported FL
Units reimbursed · per 100k residents
17.7663
gray = no data reported ⓘ
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 Kentucky 663 /100k
2 Missouri 275 /100k
3 Mississippi 257 /100k
4 New York 222 /100k
5 Georgia 206 /100k
6 New Jersey 188 /100k
7 Ohio 79.1 /100k
8 Virginia 48.1 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

💊 Medicaid utilization by pack size

Medicaid (SDUD) totals over the four most recent reported quarters for every package size of this drug — handy when a specific package (e.g. a starter/titration pack) carries little or no Medicaid volume on its own.
1 bottle this page46122-0141-25 1,117 Rx · $17,033
1 bottle46122-0141-21 999 Rx · $14,365
Drug total (last 4 qtrs): 2,116 Rx · 261,033 units · $31,398 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.

📦 Packaging — all sizes for this product

Package NDCDescription Per unit Per pack Marketing startStatus
46122-0141-21 1 BOTTLE in 1 CARTON (46122-141-21) / 89 mL in 1 BOTTLE $0.0664 / mL $5.91 2012-08-30 Active
46122-0141-25 You're viewing this 1 BOTTLE in 1 CARTON (46122-141-25) / 148 mL in 1 BOTTLE $0.0526 / mL $7.78 2013-08-02 Active

This pack has the lowest per-mL cost of the 2 priced pack sizes ($0.0526 NADAC).

In Medicaid, this is the most-dispensed pack of this product — about 53% of fills over the last four reported quarters. See all packs ↓

Pack size FAQ

What quantity is in NDC 46122-0141-25?
NDC 46122-0141-25 is listed by the FDA — 1 bottle in 1 carton / 148 ml in 1 bottle.
What NDC number is used to bill for this package of Good Neighbor Pharmacy Cough DM ER dextromethorphan polistirex 30 mg/5mL Suspension?
Bill NDC 46122-0141-25 — the 11-digit billing format is 46122014125. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.

📄 FDA label — Drug Facts FDA SPL

The complete FDA label for this product — the official Drug Facts labeling, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage ⏱️ Dosage and Administration ⚠️ Warnings 🧪 Active Ingredient 🧪 Inactive Ingredients 🎯 Purpose
🎯 Indications and Usage 33 words ▾

Uses temporarily relieves • cough due to minor throat and bronchial irritation as may occur with the common cold or inhaled irritants • the impulse to cough to help you get to sleep

⏱️ Dosage and Administration 105 words ▾

Directions • shake bottle well before use • measure only with dosing cup provided • do not use dosing cup with other products • dose as follows or as directed by doctor adults and children 12 years of age and over 10 mL every 12 hours, not to exceed 20 mL in 24 hours children 6 to under 12 years of age 5 mL every 12 hours, not to exceed 10 mL in 24 hours children 4 to under 6 years of age 2.5 mL every 12 hours, not to exceed 5 mL in 24 hours children under 4 years of age do not use

⚠️ Warnings 154 words ▾

Warnings Do not use if you are now taking a prescription monoamine oxidase inhibitor (MAOI) (certain drugs for depression, psychiatric or emotional conditions, or Parkinson’s disease), or for 2 weeks after stopping the MAOI drug. If you do not know if your prescription drug contains an MAOI, ask a doctor or pharmacist before taking this product. Allergy Alert: Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions.

Ask a doctor before use if you have • chronic cough that lasts as occurs with smoking, asthma or emphysema • cough that occurs with too much phlegm (mucus) Stop use and ask a doctor if • side effects occur. You may report side effects to FDA at 1-800-FDA-1088. • cough lasts more than 7 days, cough comes back, or occurs with fever, rash or headache that lasts. These could be signs of a serious condition.

If pregnant or breast-feeding, ask a health professional before use.

🧪 Active Ingredient 14 words ▾

Active ingredient (in each 5 mL) Dextromethorphan polistirex equivalent to 30 mg dextromethorphan hydrobromide

🧪 Inactive Ingredients 44 words ▾

Inactive Ingredients D&C Red #30 aluminum lake, D&C Yellow #10 aluminum lake, glycerin, high fructose corn syrup, methylparaben, natural and artificial orange flavor, polysorbate 80, polyvinyl acetate, povidone, propylparaben, purified water, sodium metabisulfite, sodium polystyrene sulfonate, sucrose, tartaric acid, tragacanth gum, triacetin, xanthan gum

🎯 Purpose 3 words ▾

Purpose Cough suppressant

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
← 46122-0137-34 · AmerisourceBergen 46122-0150-78 · Amerisource →
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.