| NAME |
PEG-3350/ELECTROLYTES (SUCLEAR) KIT |
| VA GENERIC NAME |
ELECTROLYTES/PEG-3350 |
| DOSAGE FORM |
KIT |
| FDA MED GUIDE |
Mag_Pot_Sod_Sulfate_Liq_(Suclear)_(2013).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| INACTIVATION DATE |
2016-01-26 00:00:00 |
| NATIONAL FORMULARY NAME |
ELECTROLYTES/PEG-3350 KIT |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
COLON ELECTROLYTE LAVAGE (SUCLEAR) KIT |
| VA PRODUCT IDENTIFIER |
C1560 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4032279 |
| EFFECTIVE DATE/TIME |
-
- 2013-04-12 00:00:00
- STATUS: ACTIVE
|
