JEVITY 1.2 CAL LIQUID (17389) VA PRODUCT (50.68)

Name	Value
NAME	JEVITY 1.2 CAL LIQUID
VA GENERIC NAME	JEVITY
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
HAZARDOUS TO DISPOSE	NO
DOT SHIPPING CODE
ACTIVE INGREDIENTS	TAURINE CHLORIDE VITAMIN K CALCIUM CASEINATE SODIUM CASEINATE RIBOFLAVIN BIOTIN VITAMIN A VITAMIN D CALCIUM IRON ZINC VITAMIN E IODINE PYRIDOXINE MAGNESIUM NIACIN PANTOTHENIC ACID PHOSPHORUS POTASSIUM CHOLINE MANGANESE SELENIUM SOY PROTEIN CHROMIUM CYANOCOBALAMIN PHYTONADIONE ASCORBIC ACID THIAMINE SODIUM FOLIC ACID
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	JEVITY LIQUID,NUTRITIONAL SUPPLEMENT
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	JEVITY 1.2 CAL LIQUID
VA PRODUCT IDENTIFIER	J0014
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	240ML CAN
MASTER ENTRY FOR VUID	YES
VUID	4024821
EFFECTIVE DATE/TIME	2006-01-24 00:00:00 STATUS: ACTIVE