PHARMALYTE INJ (5508) VA PRODUCT (50.68)

Name	Value
NAME	PHARMALYTE INJ
VA GENERIC NAME	ELECTROLYTES
DOSAGE FORM	INJ
ACTIVE INGREDIENTS	GLUCONATE STRENGTH: 5 UNITS: MEQ/20ML CHLORIDE STRENGTH: 33.5 UNITS: MEQ/20ML ACETATE STRENGTH: 40.6 UNITS: MEQ/20ML CALCIUM STRENGTH: 5 UNITS: MEQ/ML MAGNESIUM STRENGTH: 8 UNITS: MEQ/20ML POTASSIUM STRENGTH: 40.5 UNITS: MEQ/ML SODIUM STRENGTH: 25 UNITS: MEQ/20ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2008-09-02 00:00:00
DSS NUMBER	22
NATIONAL FORMULARY NAME	ELECTROLYTES INJ
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	PHARMALYTE INJ
VA PRODUCT IDENTIFIER	P0438
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4006037
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2008-09-02 00:00:00 STATUS: INACTIVE