| NAME |
PROSOURCE GELATEIN PLUS PEACH/MANGO W/MCT GEL,ORAL |
| VA GENERIC NAME |
PROSOURCE PLUS |
| DOSAGE FORM |
GEL,ORAL |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
PROSOURCE PLUS GEL,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2023-03-22 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
NUTR SUPL PROSOURCE GEL PLUS W/MCT PCH/M |
| VA PRODUCT IDENTIFIER |
N0905 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042118 |
| EFFECTIVE DATE/TIME |
-
- 2023-03-22 00:00:00
- STATUS: ACTIVE
|
