POLYETHYLENE GLYCOL 300 LIQUID (24355)    VA PRODUCT (50.68)

Name Value
NAME POLYETHYLENE GLYCOL 300 LIQUID
VA GENERIC NAME POLYETHYLENE GLYCOL 300
DOSAGE FORM MISCELLANEOUS
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME POLYETHYLENE GLYCOL 300 MISCELLANEOUS
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 POLYETHYLENE GLYCOL 300 LIQUID
VA PRODUCT IDENTIFIER P1063
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4032920
EFFECTIVE DATE/TIME
  • 2013-12-17 00:00:00
    STATUS:   ACTIVE