ENSURE HN LIQUID VANILLA (10224) VA PRODUCT (50.68)

Name	Value
NAME	ENSURE HN LIQUID VANILLA
VA GENERIC NAME	ENSURE
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS	POTASSIUM PHOSPHATE,DIBASIC STRENGTH: 370 UNITS: MG/240ML CHLORIDE STRENGTH: 310 UNITS: MG VITAMIN K STRENGTH: 15 UNITS: MCG/240ML RIBOFLAVIN STRENGTH: 0.46 UNITS: MG BIOTIN STRENGTH: 81 UNITS: MCG VITAMIN A STRENGTH: 893 UNITS: UNIT VITAMIN D STRENGTH: 72 UNITS: UNIT CUPRIC SULFATE STRENGTH: 0.36 UNITS: MG/240ML ZINC SULFATE STRENGTH: 4.02 UNITS: MG/240ML CALCIUM STRENGTH: 179 UNITS: MG ZINC STRENGTH: 4.02 UNITS: MG COPPER STRENGTH: 0.36 UNITS: MG VITAMIN E STRENGTH: 8.1 UNITS: UNIT IODINE STRENGTH: 26.8 UNITS: MCG PYRIDOXINE STRENGTH: 0.54 UNITS: MG MAGNESIUM STRENGTH: 71.5 UNITS: MG NIACIN STRENGTH: 5.36 UNITS: MG FERROUS SULFATE STRENGTH: 3.22 UNITS: MG/240ML VITAMIN A PALMITATE STRENGTH: 893 UNITS: UNIT/240ML PANTOTHENIC ACID STRENGTH: 2.68 UNITS: MG MANGANESE SULFATE STRENGTH: 0.89 UNITS: MG/240ML PHOSPHORUS STRENGTH: 179 UNITS: MG POTASSIUM STRENGTH: 370 UNITS: MG CHOLINE STRENGTH: 107 UNITS: MG MANGANESE STRENGTH: 0.89 UNITS: MG SELENIUM STRENGTH: 13 UNITS: MCG/240ML SODIUM MOLYBDATE STRENGTH: 27 UNITS: MCG/240ML CHROMIUM STRENGTH: 18 UNITS: MCG/240ML CYANOCOBALAMIN STRENGTH: 1.7 UNITS: MCG PHYTONADIONE STRENGTH: 15 UNITS: MCG ASCORBIC ACID STRENGTH: 53.6 UNITS: MG THIAMINE STRENGTH: 0.41 UNITS: MG SODIUM STRENGTH: 190 UNITS: MG PYRIDOXINE HYDROCHLORIDE STRENGTH: 0.54 UNITS: MG/240ML FOLIC ACID STRENGTH: 108 UNITS: MCG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2004-11-18 00:00:00
DSS NUMBER	14
NATIONAL FORMULARY NAME	ENSURE LIQUID
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 HN/VANILLA LIQUID
VA PRODUCT IDENTIFIER	E0177
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	240ML CAN
MASTER ENTRY FOR VUID	NO
VUID	4010599
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2005-12-08 00:00:00 STATUS: ACTIVE 2009-05-26 00:00:00 STATUS: INACTIVE 2004-11-18 00:00:00 STATUS: INACTIVE