DEXTROSE/FRUCTOSE/PHOSPHORIC ACID SOLN,ORAL (9078)    VA PRODUCT (50.68)

Name Value
NAME DEXTROSE/FRUCTOSE/PHOSPHORIC ACID SOLN,ORAL
VA GENERIC NAME DEXTROSE/FRUCTOSE/PHOSPHORIC ACID
DOSAGE FORM SOLN,ORAL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2007-09-19 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME DEXTROSE/FRUCTOSE/PHOSPHORIC ACID SOLN,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 DEXTROSE/FRUCTOSE/PHOSPHORIC AC SOLN
VA PRODUCT IDENTIFIER D0188
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4009520
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-19 00:00:00
    STATUS:   INACTIVE