HYPERLYTE CR INJ (5684) VA PRODUCT (50.68)

Name	Value
NAME	HYPERLYTE CR INJ
VA GENERIC NAME	ACETATE/CALCIUM/CHLORIDE/MAGNESIUM/POTASSIUM/SODIUM
DOSAGE FORM	INJ,SOLN
ACTIVE INGREDIENTS	CHLORIDE STRENGTH: 30 UNITS: MEQ/20ML ACETATE STRENGTH: 30 UNITS: MEQ/20ML CALCIUM STRENGTH: 5 UNITS: MEQ/20ML MAGNESIUM STRENGTH: 5 UNITS: MEQ/20ML POTASSIUM STRENGTH: 20 UNITS: MEQ/20ML SODIUM STRENGTH: 25 UNITS: MEQ/20ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	6
NATIONAL FORMULARY NAME	ACETATE/CALCIUM/CHLORIDE/MAGNESIUM/POTASSIUM/SODIUM INJ,SOLN
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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4006209
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE