S-M-A IRON FORTIFIED,INFANT FORMULA CONC,ORAL (9243) VA PRODUCT (50.68)

Name	Value
NAME	S-M-A IRON FORTIFIED,INFANT FORMULA CONC,ORAL
VA GENERIC NAME	S-M-A
DOSAGE FORM	LIQUID,NUTRITIONAL SUPPLEMENT
ACTIVE INGREDIENTS	VITAMIN K MILK,NONFAT STRENGTH: 15 UNITS: GM RIBOFLAVIN BIOTIN VITAMIN A VITAMIN D CALCIUM IRON STRENGTH: 12 UNITS: MG VITAMIN E MAGNESIUM PANTOTHENIC ACID PHOSPHORUS POTASSIUM STRENGTH: 530 UNITS: MG CHOLINE OLEO STRENGTH: 36 UNITS: GM CYANOCOBALAMIN LACTOSE STRENGTH: 72 UNITS: GM ASCORBIC ACID THIAMINE SODIUM STRENGTH: 142 UNITS: MG PYRIDOXINE HYDROCHLORIDE FOLIC ACID
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-25 00:00:00
DSS NUMBER	3
NATIONAL FORMULARY NAME	S-M-A LIQUID,ORAL
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
VA PRINT NAME	INFANT FORMULA SMA IRON FORTIFIED CONC
VA PRODUCT IDENTIFIER	S0083
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CAN
MASTER ENTRY FOR VUID	YES
VUID	4009672
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-25 00:00:00 STATUS: INACTIVE