pseudoephed-bromphen-dm

10 mg/5ml — Syrup

Uncompetitive N-methyl-D-aspartate Receptor Antagonist

Also known as: pseudoephed-bromphen-dm syrup 30-2-10 mg/5ml pseudoephed-bromphen-dm syrup 30-2-10

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 14 hours, 31 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Not Covered (applies to NDCs None
NC State Health Plan - 70/30 Standard PPO 2026 Not Covered (applies to NDCs None
NC State Health Plan - HDHP 2026 Not Covered (applies to NDCs None
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