GLUCERNA LIQUID TUBE FEEDING (11720)    VA PRODUCT (50.68)

Name Value
NAME GLUCERNA LIQUID TUBE FEEDING
VA GENERIC NAME GLUCERNA
DOSAGE FORM LIQUID,NUTRITIONAL SUPPLEMENT
HAZARDOUS TO DISPOSE NO
DOT SHIPPING CODE

ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2012-03-26 00:00:00
DSS NUMBER 2
NATIONAL FORMULARY NAME GLUCERNA 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 GLUCERNA/TUBE FEEDING
VA PRODUCT IDENTIFIER G0102
TRANSMIT TO CMOP YES
VA DISPENSE UNIT 1000ML
MASTER ENTRY FOR VUID YES
VUID 4012091
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2012-03-26 00:00:00
    STATUS:   INACTIVE