REISHI MUSHROOM EXTRACT CAP/TAB (17528)    VA PRODUCT (50.68)

Name Value
NAME REISHI MUSHROOM EXTRACT CAP/TAB
VA GENERIC NAME REISHI MUSHROOM
DOSAGE FORM CAP/TAB
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME REISHI MUSHROOM CAP/TAB
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME REISHI MUSHROOM EXTRACT CAP/TAB
VA PRODUCT IDENTIFIER R0190
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP/TAB
MASTER ENTRY FOR VUID YES
VUID 4025029
EFFECTIVE DATE/TIME
  • 2006-03-28 00:00:00
    STATUS:   ACTIVE