GLYTROL 1.0 CAL LIQUID VANILLA (26358)    VA PRODUCT (50.68)

Name Value
NAME GLYTROL 1.0 CAL LIQUID VANILLA
VA GENERIC NAME GLYTROL
DOSAGE FORM LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME GLYTROL LIQUID,NUTRITIONAL SUPPLEMENT
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 NUTRITION SUPL GLYTROL 1.0 CAL VAN LIQ
VA PRODUCT IDENTIFIER N0748
TRANSMIT TO CMOP NO
VA DISPENSE UNIT 250ML CAN
MASTER ENTRY FOR VUID YES
VUID 4035168
EFFECTIVE DATE/TIME
  • 2015-12-10 00:00:00
    STATUS:   ACTIVE