VIVONEX T.E.N. POWDER,PKT,80.4GM (12508) VA PRODUCT (50.68)

Name	Value
NAME	VIVONEX T.E.N. POWDER,PKT,80.4GM
VA GENERIC NAME	VIVONEX
DOSAGE FORM	POWDER,ORAL
ACTIVE INGREDIENTS	PHENYLALANINE TRYPTOPHAN AMINO ACIDS VITAMIN K CALCIUM PANTOTHENATE RIBOFLAVIN VITAMIN A VITAMIN D CALCIUM IRON COPPER IODINE MAGNESIUM PHOSPHORUS CYANOCOBALAMIN PHYTONADIONE THIAMINE HYDROCHLORIDE ASCORBIC ACID SODIUM STRENGTH: 20 UNITS: MEQ/L PYRIDOXINE HYDROCHLORIDE
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	1
NATIONAL FORMULARY NAME	VIVONEX 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 VIVONEX T.E.N. PWD
VA PRODUCT IDENTIFIER	N0257
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	PKT
MASTER ENTRY FOR VUID	YES
VUID	4012874
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE