ISOLYTE S/DEXTROSE 5% INJ (5451) VA PRODUCT (50.68)

Name	Value
NAME	ISOLYTE S/DEXTROSE 5% INJ
VA GENERIC NAME	DEXTROSE/ELECTROLYTES
DOSAGE FORM	INJ,SOLN
ACTIVE INGREDIENTS	SODIUM GLUCONATE STRENGTH: 500 UNITS: MG/100ML SODIUM ACETATE STRENGTH: 370 UNITS: MG/100ML SODIUM CHLORIDE STRENGTH: 530 UNITS: MG/100ML DEXTROSE STRENGTH: 5 UNITS: GM/100ML POTASSIUM CHLORIDE STRENGTH: 37 UNITS: MG/100ML MAGNESIUM CHLORIDE STRENGTH: 30 UNITS: MG/100ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	20
NATIONAL FORMULARY NAME	DEXTROSE/ELECTROLYTES INJ,SOLN
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	ISOLYTE S/DEXTROSE 5% INJ
VA PRODUCT IDENTIFIER	I0480
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4005981
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE