| NAME |
PEDIASURE PEPTIDE 1.0 CAL LIQ VANILLA |
| VA GENERIC NAME |
PEDIASURE PEPTIDE |
| DOSAGE FORM |
LIQUID,NUTRITIONAL SUPPLEMENT |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
PEDIASURE PEPTIDE LIQUID,NUTRITIONAL SUPPLEMENT |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| 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 PEDIASURE 1.0 CAL LIQUID |
| VA PRODUCT IDENTIFIER |
P0993 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
240ML CAN |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4031165 |
| EFFECTIVE DATE/TIME |
-
- 2011-12-09 00:00:00
- STATUS: ACTIVE
|
