| NAME |
PEDIASMART DAIRY PWDR VANILLA |
| VA GENERIC NAME |
PEDIASMART |
| DOSAGE FORM |
POWDER,ORAL |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
PEDIASMART POWDER,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| 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 |
NUTRITION SUPL PEDIASMART/VANILLA PWDR |
| VA PRODUCT IDENTIFIER |
N0698 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
GM |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4033883 |
| EFFECTIVE DATE/TIME |
-
- 2014-11-25 00:00:00
- STATUS: ACTIVE
|
