MULTIPLE ELECTROLYTE ADDITIVE INJ (7122) VA PRODUCT (50.68)

Name	Value
NAME	MULTIPLE ELECTROLYTE ADDITIVE INJ
VA GENERIC NAME	CALCIUM/CHLORIDE/GLUCONATE/MAGNESIUM/POTASSIUM/SODIUM/SULFATE
DOSAGE FORM	INJ,SOLN
HAZARDOUS TO DISPOSE	NO
DOT SHIPPING CODE
ACTIVE INGREDIENTS	SODIUM CHLORIDE STRENGTH: 2.33 UNITS: GM POTASSIUM CHLORIDE STRENGTH: 1.49 UNITS: GM MAGNESIUM SULFATE STRENGTH: 0.99 UNITS: GM CALCIUM GLUCONATE STRENGTH: 1.03 UNITS: GM
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	1
NATIONAL FORMULARY NAME	CALCIUM/CHLORIDE/GLUCONATE/MAGNESIUM/POTASSIUM/SODIUM/SULFATE 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	4007632
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE