GLUCERNA 1.2 CAL LIQUID (20037) VA PRODUCT (50.68)

Name	Value
NAME	GLUCERNA 1.2 CAL LIQUID
VA GENERIC NAME	GLUCERNA
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
HAZARDOUS TO DISPOSE	NO
DOT SHIPPING CODE
ACTIVE INGREDIENTS	TAURINE FRUCTOSE CHLORIDE SAFFLOWER OIL VITAMIN K CALCIUM CASEINATE SODIUM CASEINATE RIBOFLAVIN BIOTIN VITAMIN D CALCIUM IRON ZINC COPPER IODINE PYRIDOXINE MAGNESIUM VITAMIN A PALMITATE PANTOTHENIC ACID CORN STARCH INOSITOL PHOSPHORUS POTASSIUM MOLYBDENUM CHOLINE MANGANESE SOY FIBER SOY LECITHIN CHROMIUM CYANOCOBALAMIN PHYTONADIONE ASCORBIC ACID THIAMINE SODIUM FOLIC ACID
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	GLUCERNA 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	NUTRITION SUPL GLUCERNA 1.2 CAL LIQ
VA PRODUCT IDENTIFIER	G0309
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	240ML CAN
MASTER ENTRY FOR VUID	YES
VUID	4027988
EFFECTIVE DATE/TIME	2008-11-06 00:00:00 STATUS: ACTIVE