SOUR CHERRY JUICE (18154)    VA PRODUCT (50.68)

Name Value
NAME SOUR CHERRY JUICE
VA GENERIC NAME SOUR CHERRY
DOSAGE FORM LIQUID,ORAL
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME SOUR CHERRY LIQUID,ORAL
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 SOUR CHERRY JUICE
VA PRODUCT IDENTIFIER S0487
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4025898
EFFECTIVE DATE/TIME
  • 2007-03-01 00:00:00
    STATUS:   ACTIVE