| NAME |
REAL FOODS ORANGE CHICKEN,CARROT,BROWN RICE,PKT,267GM |
| VA GENERIC NAME |
REAL FOODS |
| DOSAGE FORM |
LIQUID,NUTRITIONAL SUPPLEMENT |
| HAZARDOUS TO DISPOSE |
NO |
| NATIONAL FORMULARY NAME |
REAL FOODS LIQUID,NUTRITIONAL SUPPLEMENT |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2021-11-12 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
NUTR SUPL R-FOODS CHICKEN,CARROT,B-RICE |
| VA PRODUCT IDENTIFIER |
N0874 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4040942 |
| EFFECTIVE DATE/TIME |
-
- 2021-11-12 00:00:00
- STATUS: ACTIVE
|
