PROSOURCE GELATEIN PLUS CHERRY GEL,ORAL (30678) VA PRODUCT (50.68)

Name	Value
NAME	PROSOURCE GELATEIN PLUS CHERRY GEL,ORAL
VA GENERIC NAME	PROSOURCE PLUS
DOSAGE FORM	GEL,ORAL
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	HISTIDINE ISOLEUCINE METHIONINE THREONINE TRYPTOPHAN LEUCINE
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	PROSOURCE PLUS GEL,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 0 COPAY EFFECTIVE DATE: 2021-01-28 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	NUTR SUPL PROSOURCE GELATEIN PLUS CHERRY
VA PRODUCT IDENTIFIER	N0861
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4039997
EFFECTIVE DATE/TIME	2021-01-28 00:00:00 STATUS: ACTIVE 2021-01-28 00:00:00 STATUS: ACTIVE 2021-01-28 00:00:00 STATUS: ACTIVE