BOOST GLUCOSE CONTROL LIQUID VANILLA (20841)    VA PRODUCT (50.68)

Name Value
NAME BOOST GLUCOSE CONTROL LIQUID VANILLA
VA GENERIC NAME BOOST
DOSAGE FORM LIQUID,NUTRITIONAL SUPPLEMENT
HAZARDOUS TO DISPOSE NO
DOT SHIPPING CODE

ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME BOOST 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 NUTR SUPL BOOST GLUCOSE CONTROL LIQ VAN
VA PRODUCT IDENTIFIER B0630
TRANSMIT TO CMOP NO
VA DISPENSE UNIT 240ML BTL
MASTER ENTRY FOR VUID YES
VUID 4028907
EFFECTIVE DATE/TIME
  • 2009-08-11 00:00:00
    STATUS:   ACTIVE