GLYTROL 1.0 CAL LIQUID 1000ML (26357) VA PRODUCT (50.68)

Name	Value
NAME	GLYTROL 1.0 CAL LIQUID 1000ML
VA GENERIC NAME	GLYTROL
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS	VITAMIN K BIOTIN CALCIUM CORN STARCH PHOSPHORUS POTASSIUM MANGANESE SOY LECITHIN CYANOCOBALAMIN PHYTONADIONE ASCORBIC ACID THIAMINE FOLIC ACID
NATIONAL FORMULARY NAME	GLYTROL 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 GLYTROL 1.0CAL 1000ML LIQ
VA PRODUCT IDENTIFIER	N0732
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	BTL
MASTER ENTRY FOR VUID	YES
VUID	4035167
EFFECTIVE DATE/TIME	2015-12-10 00:00:00 STATUS: ACTIVE