CORPAK PRO-MIX #22-9804 20GM/PKT PWDR (12226) VA PRODUCT (50.68)

Name	Value
NAME	CORPAK PRO-MIX #22-9804 20GM/PKT PWDR
VA GENERIC NAME	CORPAK PRO-MIX
DOSAGE FORM	POWDER,ORAL
ACTIVE INGREDIENTS	POTASSIUM STRENGTH: 117 UNITS: MG FAT STRENGTH: 0.8 UNITS: GM PROTEIN STRENGTH: 15 UNITS: GM LACTOSE SODIUM STRENGTH: 40 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-19 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	CORPAK PRO-MIX POWDER,ORAL
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 CORPAK PRO-MIX PWD
VA PRODUCT IDENTIFIER	N0236
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	PKT
MASTER ENTRY FOR VUID	YES
VUID	4012592
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-19 00:00:00 STATUS: INACTIVE