NUTRILYTE II INJ (5685) VA PRODUCT (50.68)

Name	Value
NAME	NUTRILYTE II INJ
VA GENERIC NAME	ACETATE/CALCIUM/CHLORIDE/MAGNESIUM/POTASSIUM/SODIUM
DOSAGE FORM	INJ
ACTIVE INGREDIENTS	CHLORIDE STRENGTH: 35 UNITS: MEQ/L ACETATE STRENGTH: 29.5 UNITS: MEQ/L CALCIUM STRENGTH: 4.5 UNITS: MEQ/L MAGNESIUM STRENGTH: 5 UNITS: MEQ/L POTASSIUM STRENGTH: 20 UNITS: MEQ/L SODIUM STRENGTH: 35 UNITS: MEQ/L
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	7
NATIONAL FORMULARY NAME	ACETATE/CALCIUM/CHLORIDE/MAGNESIUM/POTASSIUM/SODIUM INJ
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 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	4006210
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE