PEG-400/ELECTROLYTES SOLN (7603) VA PRODUCT (50.68)

Name	Value
NAME	PEG-400/ELECTROLYTES SOLN
VA GENERIC NAME	ELECTROLYTES/PEG-400
DOSAGE FORM	SOLN,ORAL
ACTIVE INGREDIENTS	POLYETHYLENE GLYCOL 400 STRENGTH: 31.87 UNITS: GM SODIUM SULFATE STRENGTH: 5.7 UNITS: GM SODIUM CHLORIDE STRENGTH: 1.46 UNITS: GM POTASSIUM CHLORIDE STRENGTH: 0.75 UNITS: GM SODIUM BICARBONATE STRENGTH: 1.68 UNITS: GM
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2008-10-15 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	ELECTROLYTES/PEG-400 SOLN,ORAL
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
VA PRINT NAME	COLON ELECTROLYTE LAVAGE PWD FOR SOLN
VA PRODUCT IDENTIFIER	P0011
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4008099
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2008-10-15 00:00:00 STATUS: INACTIVE