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Acetaminophen, Dextromethorphan HBr, Guafeisin USP, Phenylephrine HCl 250 mg/10mL / 13.33 mg/10mL / 200 mg/10mL / 5 mg/10mL Medicare Part D Coverage

Brand name: Tesalon Children
Dosage form
SYRUP
Route
ORAL
0%
of Medicare Part D plans
cover Acetaminophen, Dextromethorphan HBr, Guafeisin USP, Phenylephrine HCl

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Frequently Asked Questions about Acetaminophen, Dextromethorphan HBr, Guafeisin USP, Phenylephrine HCl

0% of Medicare Part D plans cover Acetaminophen, Dextromethorphan HBr, Guafeisin USP, Phenylephrine HCl. Coverage varies by plan and geographic area.

Costs vary by plan. Enter your ZIP code above to see exact prices for plans in your area.

The tier placement for Acetaminophen, Dextromethorphan HBr, Guafeisin USP, Phenylephrine HCl varies by plan. Compare plans to find the best tier for your medication.

0% of plans require prior authorization for Acetaminophen, Dextromethorphan HBr, Guafeisin USP, Phenylephrine HCl. Prior authorization means your doctor must confirm the drug is medically necessary before the plan will cover it.

Coverage statistics based on CMS formulary data for plan year 2026. Data updated regularly. Methodology →