JEVITY 1.2 CAL LIQUID 1000ML (17390)    VA PRODUCT (50.68)

Name Value
NAME JEVITY 1.2 CAL LIQUID 1000ML
VA GENERIC NAME JEVITY
DOSAGE FORM LIQUID,NUTRITIONAL SUPPLEMENT
HAZARDOUS TO DISPOSE NO
DOT SHIPPING CODE

CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME JEVITY 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 JEVITY 1.2 CAL LIQUID 1000ML
VA PRODUCT IDENTIFIER J0007
TRANSMIT TO CMOP YES
VA DISPENSE UNIT BTL
MASTER ENTRY FOR VUID YES
VUID 4024822
EFFECTIVE DATE/TIME
  • 2006-01-24 00:00:00
    STATUS:   ACTIVE