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    NDC 63824-0173-65 Delsym (Dextromethorphan) 30 mg/5mL Details

    Delsym (Dextromethorphan) 30 mg/5mL

    Delsym (Dextromethorphan) is a ORAL SUSPENSION, EXTENDED RELEASE in the HUMAN OTC DRUG category. It is labeled and distributed by RB Health (US) LLC. The primary component is DEXTROMETHORPHAN.

    Product Information

    NDC 63824-0173
    Product ID 63824-173_df6b0971-5c43-43cc-8d0b-6d37d964ef87
    Associated GPIs 4310203060G110
    GCN Sequence Number 004630
    GCN Sequence Number Description dextromethorphan polistirex SUS ER 12H 30 MG/5 ML ORAL
    HIC3 H6C
    HIC3 Description ANTITUSSIVES, NON-OPIOID
    GCN 17802
    HICL Sequence Number 010295
    HICL Sequence Number Description DEXTROMETHORPHAN POLISTIREX
    Brand/Generic Brand
    Proprietary Name Delsym (Dextromethorphan)
    Proprietary Name Suffix n/a
    Non-Proprietary Name Dextromethorphan
    Product Type HUMAN OTC DRUG
    Dosage Form SUSPENSION, EXTENDED RELEASE
    Route ORAL
    Active Ingredient Strength 30
    Active Ingredient Units mg/5mL
    Substance Name DEXTROMETHORPHAN
    Labeler Name RB Health (US) LLC
    Pharmaceutical Class Sigma-1 Agonist [EPC], Sigma-1 Receptor Agonists [MoA], Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC], Uncompetitive NMDA Receptor Antagonists [MoA]
    DEA Schedule n/a
    Marketing Category NDA
    Application Number NDA018658
    Listing Certified Through 2024-12-31

    Package

    NDC 63824-0173-65 (63824017365)

    NDC Package Code 63824-173-65
    Billing NDC 63824017365
    Package 1 BOTTLE in 1 CARTON (63824-173-65) / 148 mL in 1 BOTTLE
    Marketing Start Date 2011-08-19
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 0.07651
    Pricing Unit ML
    Effective Date 2024-02-21
    NDC Description CHILD DELSYM COUGH 30 MG/5 ML
    Pharmacy Type Indicator C/I
    OTC Y
    Explanation Code 1, 5
    Classification for Rate Setting B
    As of Date 2024-02-21
    This pricing file, entitled the NADAC (National Average Drug Acquisition Cost) files, provide state Medicaid agencies with covered outpatient drug prices by averaging survey invoice prices from retail community pharmacies across the United States. These pharmacies include independent retail community pharmacies and chain pharmacies. The prices are updated on a weekly and monthly basis

    Standard Product Labeling (SPL)/Prescribing Information SPL bb0116d0-93e4-44e2-b0e4-c0b773eced6f Details

    Revised: 6/2022