ENSURE W/FIBER LIQUID VANILLA (10235) VA PRODUCT (50.68)

Name	Value
NAME	ENSURE W/FIBER LIQUID VANILLA
VA GENERIC NAME	ENSURE
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS	CHLORIDE STRENGTH: 320 UNITS: MG/240ML VITAMIN K STRENGTH: 14 UNITS: MCG/240ML SUCROSE CALCIUM CASEINATE SODIUM CASEINATE SOY PROTEIN ISOLATE RIBOFLAVIN STRENGTH: 0.44 UNITS: MG/240ML BIOTIN STRENGTH: 77 UNITS: MCG/240ML VITAMIN D STRENGTH: 68 UNITS: UNIT/240ML CALCIUM STRENGTH: 170 UNITS: MG/240ML IRON STRENGTH: 3.06 UNITS: MG/240ML ZINC STRENGTH: 3.83 UNITS: MG/240ML COPPER STRENGTH: 0.34 UNITS: MG/240ML VITAMIN E STRENGTH: 7.7 UNITS: UNIT/240ML IODINE STRENGTH: 25.5 UNITS: MCG/240ML MAGNESIUM STRENGTH: 68 UNITS: MG/240ML NIACIN STRENGTH: 5.1 UNITS: MG/240ML VITAMIN A PALMITATE STRENGTH: 850 UNITS: UNIT/240ML PANTOTHENIC ACID STRENGTH: 2.55 UNITS: MG/240ML CORN OIL CORN STARCH,HYDROLYZED PHOSPHORUS STRENGTH: 170 UNITS: MG/240ML POTASSIUM STRENGTH: 400 UNITS: MG/240ML MOLYBDENUM STRENGTH: 26 UNITS: MCG/240ML CHOLINE STRENGTH: 102 UNITS: MG/240ML MANGANESE STRENGTH: 0.85 UNITS: MG/240ML SELENIUM STRENGTH: 12 UNITS: MCG/240ML SOY FIBER STRENGTH: 5000 UNITS: MG/240ML SOY LECITHIN CHROMIUM STRENGTH: 17 UNITS: MCG/240ML CYANOCOBALAMIN STRENGTH: 1.6 UNITS: MCG/240ML PHYTONADIONE THIAMINE HYDROCHLORIDE STRENGTH: 0.39 UNITS: MG/240ML ASCORBIC ACID STRENGTH: 51 UNITS: MCG/240ML SODIUM STRENGTH: 200 UNITS: MG/240ML PYRIDOXINE HYDROCHLORIDE STRENGTH: 0.51 UNITS: MG/240ML FOLIC ACID STRENGTH: 102 UNITS: MCG/240ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	25
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 W/FIBER/VAN LIQUID
VA PRODUCT IDENTIFIER	E0165
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	240ML CAN
MASTER ENTRY FOR VUID	YES
VUID	4010609
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE