PEG-3350/LYTES (EQV-NULYTELY) ORAL PWDR (30348)    VA PRODUCT (50.68)

Name Value
NAME PEG-3350/LYTES (EQV-NULYTELY) ORAL PWDR
VA GENERIC NAME ELECTROLYTES/PEG-3350
DOSAGE FORM PWDR,RENST-ORAL
FDA MED GUIDE PEG-3350_(Generic)_(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
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2020-08-21 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME PEG-3350/LYTES (EQV-NULYTELY) ORAL PWDR
VA PRODUCT IDENTIFIER P1239
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4039633
EFFECTIVE DATE/TIME
  • 2020-08-21 00:00:00
    STATUS:   ACTIVE
  • 2020-08-21 00:00:00
    STATUS:   ACTIVE
  • 2020-08-21 00:00:00
    STATUS:   ACTIVE