FRUCTOSE 5%/ELECTROLYTE NO.48 INJ (6699) VA PRODUCT (50.68)

Name	Value
NAME	FRUCTOSE 5%/ELECTROLYTE NO.48 INJ
VA GENERIC NAME	ELECTROLYTES/FRUCTOSE
DOSAGE FORM	INJ,SOLN
ACTIVE INGREDIENTS	SODIUM LACTATE STRENGTH: 260 UNITS: MG/100ML FRUCTOSE STRENGTH: 5 UNITS: GM/100ML POTASSIUM PHOSPHATE,MONOBASIC STRENGTH: 20 UNITS: MG/100ML SODIUM CHLORIDE STRENGTH: 12 UNITS: MG/100ML POTASSIUM CHLORIDE STRENGTH: 141 UNITS: MG/100ML MAGNESIUM CHLORIDE STRENGTH: 31 UNITS: MG/100ML
CS FEDERAL SCHEDULE	Unscheduled
DSS NUMBER	3
NATIONAL FORMULARY NAME	ELECTROLYTES/FRUCTOSE 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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4007215
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE