WILD CHERRY SYRUP (9560)    VA PRODUCT (50.68)

Name Value
NAME WILD CHERRY SYRUP
VA GENERIC NAME ALCOHOL/CHERRY JUICE/SUCROSE
DOSAGE FORM SYRUP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2004-11-19 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME ALCOHOL/CHERRY JUICE/SUCROSE SYRUP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME WILD CHERRY SYRUP
VA PRODUCT IDENTIFIER W0033
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID NO
VUID 4009976
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2005-12-08 00:00:00
    STATUS:   ACTIVE
  • 2008-09-02 00:00:00
    STATUS:   INACTIVE
  • 2004-11-19 00:00:00
    STATUS:   INACTIVE