NOVASOURCE RENAL LIQUID (CAFE MOCHA) (30045) VA PRODUCT (50.68)

Name	Value
NAME	NOVASOURCE RENAL LIQUID (CAFE MOCHA)
VA GENERIC NAME	NOVASOURCE
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	TAURINE CHLORIDE VITAMIN K RIBOFLAVIN BIOTIN VITAMIN C VITAMIN A VITAMIN D CALCIUM ZINC COPPER VITAMIN E IODINE MAGNESIUM NIACIN PANTOTHENIC ACID PHOSPHORUS POTASSIUM MANGANESE SELENIUM L-CARNITINE VITAMIN B6 THIAMINE SODIUM FOLIC ACID
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	NOVASOURCE LIQUID,NUTRITIONAL SUPPLEMENT
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 0 COPAY EFFECTIVE DATE: 2020-04-02 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	NOVASOURCE RENAL LIQUID (CAFE MOCHA)
VA PRODUCT IDENTIFIER	N0845
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	240ML BOX
MASTER ENTRY FOR VUID	YES
VUID	4039284
EFFECTIVE DATE/TIME	2020-04-02 00:00:00 STATUS: ACTIVE