ISOCAL HN (VANILLA) LIQUID,240ML (12490) VA PRODUCT (50.68)

Name	Value
NAME	ISOCAL HN (VANILLA) LIQUID,240ML
VA GENERIC NAME	ISOCAL
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS	AMINO ACIDS VITAMIN K CALCIUM CASEINATE SODIUM CASEINATE CORN SYRUP SOY OIL,PARTIALLY HYDROGENATED VITAMIN A VITAMIN D CALCIUM VITAMIN E PHOSPHORUS SOY LECITHIN TRIGLYCERIDES,MEDIUM CHAIN VITAMIN B3 CYANOCOBALAMIN VITAMIN B5 VITAMIN B1 VITAMIN B2 VITAMIN B6 ASCORBIC ACID
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2010-07-15 00:00:00
DSS NUMBER	4
NATIONAL FORMULARY NAME	ISOCAL 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 ISOCAL HN/VANILLA LIQUID
VA PRODUCT IDENTIFIER	N0309
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CAN
MASTER ENTRY FOR VUID	YES
VUID	4012856
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2010-07-15 00:00:00 STATUS: INACTIVE