| NAME |
PROSOURCE GELATEIN 20 GRAPE GEL,ORAL |
| VA GENERIC NAME |
PROSOURCE PLUS |
| DOSAGE FORM |
GEL,ORAL |
| HAZARDOUS TO DISPOSE |
NO |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
PROSOURCE PLUS GEL,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2021-03-11 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
NUTR SUPL PROSOURCE GELATEIN 20 GRAPE |
| VA PRODUCT IDENTIFIER |
N0862 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4040195 |
| EFFECTIVE DATE/TIME |
-
- 2021-03-11 00:00:00
- STATUS: ACTIVE
-
- 2021-03-11 00:00:00
- STATUS: ACTIVE
-
- 2021-03-11 00:00:00
- STATUS: ACTIVE
|