| NAME |
PSYLLIUM 3.4GM WAFER,ORAL |
| VA GENERIC NAME |
PSYLLIUM |
| DOSAGE FORM |
WAFER,ORAL |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
3.4 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
GM |
| NATIONAL FORMULARY NAME |
PSYLLIUM WAFER |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
- COPAY END DATE: 2021-12-31 00:00:00
-
- COPAY TIER LEVEL: 1
- COPAY EFFECTIVE DATE: 2022-01-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
PSYLLIUM 3.4GM ORAL WAFER |
| VA PRODUCT IDENTIFIER |
P0731 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4024659 |
| EFFECTIVE DATE/TIME |
-
- 2006-01-24 00:00:00
- STATUS: ACTIVE
|
