ENSURE PLUS HN LIQUID TUBE FEEDING (10227) VA PRODUCT (50.68)

Name	Value
NAME	ENSURE PLUS HN LIQUID TUBE FEEDING
VA GENERIC NAME	ENSURE
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS	POTASSIUM CITRATE STRENGTH: 430 UNITS: MG/240ML CHROMIC CHLORIDE STRENGTH: 25 UNITS: MCG/240ML TAURINE CHLORIDE STRENGTH: 380 UNITS: MG/240ML VITAMIN K STRENGTH: 20 UNITS: MCG/240ML SUCROSE CALCIUM CASEINATE SODIUM CASEINATE SOY PROTEIN ISOLATE RIBOFLAVIN STRENGTH: 0.85 UNITS: MG/240ML BIOTIN STRENGTH: 150 UNITS: MCG/240ML VITAMIN D STRENGTH: 100 UNITS: UNIT/240ML CUPRIC SULFATE STRENGTH: 0.5 UNITS: MG/240ML ZINC SULFATE STRENGTH: 5.63 UNITS: MG/240ML CALCIUM STRENGTH: 250 UNITS: MG/240ML IODINE STRENGTH: 37.5 UNITS: MCG/240ML FERROUS SULFATE STRENGTH: 4.5 UNITS: MG/240ML VITAMIN A PALMITATE STRENGTH: 1250 UNITS: UNIT/240ML PANTOTHENIC ACID STRENGTH: 5 UNITS: MG/240ML CARRAGEENAN CHOLINE CHLORIDE STRENGTH: 150 UNITS: MG/240ML CORN OIL CORN STARCH,HYDROLYZED MANGANESE SULFATE STRENGTH: 1.25 UNITS: MG/240ML PHOSPHORUS STRENGTH: 250 UNITS: MG/240ML SELENIUM STRENGTH: 18 UNITS: MCG/240ML SODIUM MOLYBDATE STRENGTH: 38 UNITS: MCG/240ML SOY LECITHIN CYANOCOBALAMIN STRENGTH: 3 UNITS: MCG/240ML THIAMINE HYDROCHLORIDE STRENGTH: 0.75 UNITS: MG/240ML SODIUM CITRATE STRENGTH: 280 UNITS: MG/240ML ASCORBIC ACID STRENGTH: 75 UNITS: MG/240ML PYRIDOXINE HYDROCHLORIDE STRENGTH: 1 UNITS: MG/240ML MAGNESIUM CHLORIDE STRENGTH: 100 UNITS: MG/240ML FOLIC ACID STRENGTH: 200 UNITS: MCG/240ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	16
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 PLUS HN/TUBE FEED
VA PRODUCT IDENTIFIER	E0164
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	1000ML
MASTER ENTRY FOR VUID	YES
VUID	4010601
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE