CUSTODIOL HTK SOLN (28666) VA PRODUCT (50.68)

Name	Value
NAME	CUSTODIOL HTK SOLN
VA GENERIC NAME	ELECTROLYTES
DOSAGE FORM	SOLN,IRRG
ACTIVE INGREDIENTS	HISTIDINE TRYPTOPHAN MANNITOL SODIUM CHLORIDE POTASSIUM CHLORIDE CALCIUM CHLORIDE MAGNESIUM CHLORIDE
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	ELECTROLYTES SOLN,IRRG
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	No Possible Dosages
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 0 COPAY EFFECTIVE DATE: 2018-07-31 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	CUSTODIOL HTK SOLN
VA PRODUCT IDENTIFIER	C1858
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4037710
EFFECTIVE DATE/TIME	2018-08-02 00:00:00 STATUS: ACTIVE