| NAME |
PEG-3350/ELECTROLYTES (PLENVU) PWDR,PKTS |
| VA GENERIC NAME |
ELECTROLYTES/PEG-3350 |
| DOSAGE FORM |
PWDR,RENST-ORAL |
| FDA MED GUIDE |
PEG-3350_(Plenvu)_(2019).PDF |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
ELECTROLYTES/PEG-3350 PWDR,RENST-ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2019-01-14 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
COLON ELEC LAVAGE PKTS (PLENVU) FOR SOLN |
| VA PRODUCT IDENTIFIER |
C1881 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4038101 |
| EFFECTIVE DATE/TIME |
-
- 2019-01-14 00:00:00
- STATUS: ACTIVE
|
