PROTAIN XL TUBE FEEDING,CAN,250ML (12363) VA PRODUCT (50.68)

Name	Value
NAME	PROTAIN XL TUBE FEEDING,CAN,250ML
VA GENERIC NAME	PROTAIN XL
DOSAGE FORM	MISCELLANEOUS
ACTIVE INGREDIENTS	WATER VITAMIN K STRENGTH: 15 UNITS: MCG/240ML RIBOFLAVIN STRENGTH: 0.68 UNITS: MG/240ML BIOTIN STRENGTH: 0.09 UNITS: MG/240ML VITAMIN A STRENGTH: 2000 UNITS: UNIT/240ML VITAMIN D STRENGTH: 100 UNITS: UNIT/240ML CALCIUM STRENGTH: 200 UNITS: MG/240ML PYRIDOXINE STRENGTH: 0.8 UNITS: MG/240ML PANTOTHENIC ACID STRENGTH: 3 UNITS: MG/240ML CHOLINE STRENGTH: 125 UNITS: MG/240ML CYANOCOBALAMIN STRENGTH: 2.4 UNITS: MG/240ML THIAMINE HYDROCHLORIDE STRENGTH: 0.6 UNITS: MG/240ML ASCORBIC ACID STRENGTH: 60 UNITS: MG/240ML FOLIC ACID STRENGTH: 0.12 UNITS: MG/240ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-25 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	PROTAIN XL MISCELLANEOUS
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 PROTAIN XL TUBE FEEDING
VA PRODUCT IDENTIFIER	N0247
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	240ML CAN
MASTER ENTRY FOR VUID	YES
VUID	4012729
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-25 00:00:00 STATUS: INACTIVE