| NAME |
FECAL MICROBIOTA SPORE,LIVE-BRPK CAP,ORAL |
| VA GENERIC NAME |
FECAL MICROBIOTA-BRPK |
| DOSAGE FORM |
CAP,ORAL |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY NAME |
FECAL MICROBIOTA-BRPK CAP,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2023-05-11 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
FECAL MICROBIOTA SPORE,LIVE-BRPK CAP |
| VA PRODUCT IDENTIFIER |
F0748 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
CAP |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042228 |
| EFFECTIVE DATE/TIME |
-
- 2023-05-11 00:00:00
- STATUS: ACTIVE
|
