| Name | Value |
|---|---|
| NAME | SIMPLE SYRUP |
| VA GENERIC NAME | SUGAR/WATER |
| DOSAGE FORM | SYRUP |
| ACTIVE INGREDIENTS | |
| CS FEDERAL SCHEDULE | Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT | Multisource |
| DSS NUMBER | 1 |
| NATIONAL FORMULARY NAME | SUGAR/WATER SYRUP |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| CODING SYSTEM |
|
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| TRANSMIT TO CMOP | NO |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4009818 |
| EFFECTIVE DATE/TIME |
|