AMYLASE 39000UNT/LIPASE 12000UNT/PROTEASE 39000UNT CAP (4188) VA PRODUCT (50.68)

Name	Value
NAME	AMYLASE 39000UNT/LIPASE 12000UNT/PROTEASE 39000UNT CAP
VA GENERIC NAME	AMYLASE/LIPASE/PROTEASE
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	AMYLASE STRENGTH: 39000 UNITS: UNIT LIPASE STRENGTH: 12000 UNITS: UNIT PROTEASE STRENGTH: 39000 UNITS: UNIT
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	16
NATIONAL FORMULARY NAME	AMYLASE/LIPASE/PROTEASE CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	ULTRASE MT 12 CAP
VA PRODUCT IDENTIFIER	U0011
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4004740
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE