ENSURE PLUS LIQUID VANILLA (10234) VA PRODUCT (50.68)

Name	Value
NAME	ENSURE PLUS LIQUID VANILLA
VA GENERIC NAME	ENSURE
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS	CHLORIDE STRENGTH: 450 UNITS: MG/240ML VITAMIN K STRENGTH: 14 UNITS: MCG/240ML SUCROSE CALCIUM CASEINATE SODIUM CASEINATE SOY PROTEIN ISOLATE CORN SYRUP RIBOFLAVIN STRENGTH: 0.57 UNITS: MG/240ML BIOTIN STRENGTH: 100 UNITS: MCG/240ML VITAMIN D STRENGTH: 67 UNITS: UNIT/240ML CALCIUM STRENGTH: 167 UNITS: MG/240ML IRON STRENGTH: 3 UNITS: MG/240ML ZINC STRENGTH: 3.75 UNITS: MG/240ML COPPER STRENGTH: 0.34 UNITS: MG/240ML IODINE STRENGTH: 25 UNITS: MCG/240ML MAGNESIUM STRENGTH: 67 UNITS: MG/240ML VITAMIN A PALMITATE STRENGTH: 834 UNITS: UNIT/240ML PANTOTHENIC ACID STRENGTH: 3.34 UNITS: MG/240ML CARRAGEENAN CORN OIL PHOSPHORUS STRENGTH: 167 UNITS: MG/240ML POTASSIUM STRENGTH: 460 UNITS: MG/240ML MOLYBDENUM STRENGTH: 25 UNITS: MCG/240ML CHOLINE STRENGTH: 100 UNITS: MG/240ML MANGANESE STRENGTH: 0.83 UNITS: MG/240ML SELENIUM STRENGTH: 12 UNITS: MCG/240ML SOY LECITHIN CHROMIUM STRENGTH: 17 UNITS: MCG/240ML CYANOCOBALAMIN STRENGTH: 2 UNITS: MCG/240ML PHYTONADIONE THIAMINE HYDROCHLORIDE STRENGTH: 0.5 UNITS: MG/240ML ASCORBIC ACID STRENGTH: 50 UNITS: MG/240ML SODIUM STRENGTH: 250 UNITS: MG/240ML PYRIDOXINE HYDROCHLORIDE STRENGTH: 0.67 UNITS: MG/240ML FOLIC ACID STRENGTH: 134 UNITS: MCG/240ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	24
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 PLUS/VANILLA LIQ
VA PRODUCT IDENTIFIER	E0173
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	240ML CAN
MASTER ENTRY FOR VUID	YES
VUID	4010608
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE