THEANINE CAP/TAB (23223)    VA PRODUCT (50.68)

Name Value
NAME THEANINE CAP/TAB
VA GENERIC NAME THEANINE
DOSAGE FORM CAP/TAB
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME THEANINE CAP/TAB
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 THEANINE CAP/TAB
VA PRODUCT IDENTIFIER T0804
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP/TAB
MASTER ENTRY FOR VUID YES
VUID 4031648
EFFECTIVE DATE/TIME
  • 2012-09-10 00:00:00
    STATUS:   ACTIVE