JEVITY 1 CAL LIQUID (18134)    VA PRODUCT (50.68)

Name Value
NAME JEVITY 1 CAL LIQUID
VA GENERIC NAME JEVITY
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 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 CAL LIQUID
VA PRODUCT IDENTIFIER J0019
TRANSMIT TO CMOP NO
VA DISPENSE UNIT 240ML CAN
MASTER ENTRY FOR VUID YES
VUID 4025865
EFFECTIVE DATE/TIME
  • 2007-01-25 00:00:00
    STATUS:   ACTIVE