| NAME |
AMINOLEVULINIC ACID 30MG/ML SOLN,ORAL |
| VA GENERIC NAME |
AMINOLEVULINIC ACID |
| DOSAGE FORM |
PWDR,RENST-ORAL |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
30 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
MG/ML |
| NATIONAL FORMULARY NAME |
AMINOLEVULINIC ACID PWDR,RENST-ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2018-10-12 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
AMINOLEVULINIC ACID 30MG/ML ORAL SOLN |
| VA PRODUCT IDENTIFIER |
A1992 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037921 |
| EFFECTIVE DATE/TIME |
-
- 2018-10-15 00:00:00
- STATUS: ACTIVE
|
