PEPTAMEN INTENSE VHP LIQUID (26595) VA PRODUCT (50.68)

Name	Value
NAME	PEPTAMEN INTENSE VHP LIQUID
VA GENERIC NAME	PEPTAMEN
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS	TAURINE VITAMIN K CALCIUM CITRATE CALCIUM PANTOTHENATE NIACINAMIDE RIBOFLAVIN BIOTIN MAGNESIUM OXIDE POTASSIUM IODIDE ZINC SULFATE VITAMIN E FERROUS SULFATE CALCIUM PHOSPHATE CHOLECALCIFEROL COPPER SULFATE MANGANESE (AS SULFATE) SODIUM MOLYBDATE CHROMIUM CYANOCOBALAMIN BETA CAROTENE RETINYL PALMITATE L-CARNITINE PHYTONADIONE POTASSIUM CHLORIDE ASCORBIC ACID SODIUM PHOSPHATE PYRIDOXINE HYDROCHLORIDE MAGNESIUM CHLORIDE FOLIC ACID
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	PEPTAMEN 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	NUTR SUPL PEPTAMEN INTENSE VHP LIQ
VA PRODUCT IDENTIFIER	N0763
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	250ML CAN
MASTER ENTRY FOR VUID	YES
VUID	4035429
EFFECTIVE DATE/TIME	2016-02-22 00:00:00 STATUS: ACTIVE