ISOSOURCE 1.5 CAL LIQUID,250ML (15403)    VA PRODUCT (50.68)

Name Value
NAME ISOSOURCE 1.5 CAL LIQUID,250ML
VA GENERIC NAME ISOSOURCE 1.5
DOSAGE FORM LIQUID,NUTRITIONAL SUPPLEMENT
HAZARDOUS TO DISPOSE NO
DOT SHIPPING CODE

ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME ISOSOURCE 1.5 LIQUID,NUTRITIONAL SUPPLEMENT
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME ISOSOURCE 1.5 CAL LIQUID,250ML
VA PRODUCT IDENTIFIER I0329
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAN
MASTER ENTRY FOR VUID YES
VUID 4015766
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE