FREE AMINO ACID DIET (F.A.A.) 1000ML (18130) VA PRODUCT (50.68)

Name	Value
NAME	FREE AMINO ACID DIET (F.A.A.) 1000ML
VA GENERIC NAME	FREE AMINO ACID DIET
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS	SOYBEAN OIL WATER VITAMIN K MALTODEXTRIN NIACINAMIDE BIOTIN POTASSIUM IODIDE VITAMIN C VITAMIN A VITAMIN D CALCIUM IRON ZINC COPPER VITAMIN E MAGNESIUM CANOLA OIL POTASSIUM CHOLINE SOY LECITHIN XANTHAN GUM CYANOCOBALAMIN PHYTONADIONE VITAMIN B1 THIAMINE FOLIC ACID
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	FREE AMINO ACID DIET LIQUID,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 F.A.A. LIQUID 1000ML
VA PRODUCT IDENTIFIER	F0389
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	BTL
MASTER ENTRY FOR VUID	YES
VUID	4025861
EFFECTIVE DATE/TIME	2007-01-25 00:00:00 STATUS: ACTIVE