FREE AMINO ACID DIET (F.A.A.) LIQUID (18129)    VA PRODUCT (50.68)

Name Value
NAME FREE AMINO ACID DIET (F.A.A.) LIQUID
VA GENERIC NAME FREE AMINO ACID DIET
DOSAGE FORM LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2016-01-22 00:00:00
NATIONAL FORMULARY NAME FREE AMINO ACID DIET LIQUID,ORAL
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 NUTRITION SUPL F.A.A. LIQUID
VA PRODUCT IDENTIFIER F0390
TRANSMIT TO CMOP YES
VA DISPENSE UNIT 250ML CAN
MASTER ENTRY FOR VUID YES
VUID 4025860
EFFECTIVE DATE/TIME
  • 2007-01-25 00:00:00
    STATUS:   ACTIVE