| NAME |
K PHOSPHATE 155MG/NA BIPHOSPHATE 130MG/NA PHOSPHATE 852MG TAB |
| VA GENERIC NAME |
POTASSIUM PHOSPHATE/SODIUM BIPHOSPHATE/SODIUM PHOSPHATE |
| DOSAGE FORM |
TAB |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| INACTIVATION DATE |
2016-03-30 00:00:00 |
| DSS NUMBER |
1 |
| NATIONAL FORMULARY NAME |
POTASSIUM PHOSPHATE/SODIUM BIPHOSPHATE/SODIUM PHOSPHATE TAB |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
K PHOS 155/NA BIPHOS 130/PHOS 852MG TAB |
| VA PRODUCT IDENTIFIER |
XV089 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
TAB |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4006922 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
|