GLYCERIN 8.6M CPD (79.2%) SOLN (7515) VA PRODUCT (50.68)

Name	Value
NAME	GLYCERIN 8.6M CPD (79.2%) SOLN
VA GENERIC NAME	CITRIC ACID/DEXTROSE/FRUCTOSE/GLYCERIN
DOSAGE FORM	SOLN
ACTIVE INGREDIENTS	FRUCTOSE STRENGTH: 1 UNITS: GM GLYCERIN STRENGTH: 79.2 UNITS: GM DEXTROSE STRENGTH: 6 UNITS: GM CITRIC ACID STRENGTH: 0.006 UNITS: GM EDETATE DISODIUM STRENGTH: 0.3 UNITS: GM
CS FEDERAL SCHEDULE	Unscheduled
DSS NUMBER	1
NATIONAL FORMULARY NAME	CITRIC ACID/DEXTROSE/FRUCTOSE/GLYCERIN 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	4008019
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE