ENSURE LIQUID VANILLA (10221) VA PRODUCT (50.68)

Name	Value
NAME	ENSURE LIQUID VANILLA
VA GENERIC NAME	ENSURE
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS	CHLORIDE STRENGTH: 310 UNITS: MG RIBOFLAVIN STRENGTH: 0.43 UNITS: MG BIOTIN STRENGTH: 75 UNITS: MCG VITAMIN A STRENGTH: 625 UNITS: UNIT VITAMIN D STRENGTH: 50 UNITS: UNIT CALCIUM STRENGTH: 125 UNITS: MG ZINC STRENGTH: 2.82 UNITS: MG COPPER STRENGTH: 0.25 UNITS: MG IODINE STRENGTH: 18.8 UNITS: MCG PYRIDOXINE STRENGTH: 0.5 UNITS: MG MAGNESIUM STRENGTH: 50 UNITS: MG PANTOTHENIC ACID STRENGTH: 2.5 UNITS: MG PHOSPHORUS STRENGTH: 125 UNITS: MG POTASSIUM STRENGTH: 370 UNITS: MG CHOLINE STRENGTH: 75 UNITS: MG MANGANESE STRENGTH: 0.62 UNITS: MG CYANOCOBALAMIN STRENGTH: 1.5 UNITS: MCG PHYTONADIONE STRENGTH: 10 UNITS: MCG ASCORBIC ACID STRENGTH: 37.5 UNITS: MG THIAMINE STRENGTH: 0.38 UNITS: MG SODIUM STRENGTH: 200 UNITS: MG FOLIC ACID STRENGTH: 100 UNITS: MCG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	10
NATIONAL FORMULARY NAME	ENSURE LIQUID,NUTRITIONAL SUPPLEMENT
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	NUTRITION SUPL ENSURE/VANILLA LIQUID
VA PRODUCT IDENTIFIER	E0175
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	240ML CAN
MASTER ENTRY FOR VUID	YES
VUID	4010596
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE