| NAME |
BETAINE 1GM/1.7GM PWDR,ORAL |
| VA GENERIC NAME |
BETAINE |
| DOSAGE FORM |
POWDER,ORAL |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
1 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
GM/1.7GM |
| DSS NUMBER |
1 |
| NATIONAL FORMULARY NAME |
BETAINE POWDER,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
- COPAY END DATE: 2022-03-23 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2022-03-24 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
BETAINE 1GM/1.7GM ORAL PWDR |
| VA PRODUCT IDENTIFIER |
B0309 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
GM |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4013002 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2018-02-13 00:00:00
- STATUS: ACTIVE
-
- 2021-10-18 00:00:00
- STATUS: INACTIVE
-
- 2021-10-18 00:00:00
- STATUS: INACTIVE
-
- 2021-10-18 00:00:00
- STATUS: INACTIVE
-
- 2021-10-18 00:00:00
- STATUS: INACTIVE
-
- 2022-03-29 00:00:00
- STATUS: ACTIVE
|