ISOSOURCE LIQUID (VANILLA) (9463) VA PRODUCT (50.68)

Name	Value
NAME	ISOSOURCE LIQUID (VANILLA)
VA GENERIC NAME	ISOSOURCE
DOSAGE FORM	LIQUID
HAZARDOUS TO DISPOSE	NO
DOT SHIPPING CODE
ACTIVE INGREDIENTS	POTASSIUM CITRATE CALCIUM CASEINATE SODIUM CASEINATE SOY PROTEIN ISOLATE ZINC SULFATE FERROUS SULFATE CALCIUM PHOSPHATE,TRIBASIC CANOLA OIL CARRAGEENAN CHOLINE CHLORIDE CORN STARCH,HYDROLYZED FLAVOR,ARTIFICIAL HIGH CHROMIUM YEAST HIGH SELENIUM YEAST SOY LECITHIN TRIGLYCERIDES,MEDIUM CHAIN WATER,DEIONIZED POTASSIUM CHLORIDE SODIUM CITRATE SODIUM ASCORBATE MAGNESIUM CHLORIDE
CS FEDERAL SCHEDULE	Unscheduled
STRENGTH	1.2
INACTIVATION DATE	2003-08-12 00:00:00
UNITS	CAL/ML
DSS NUMBER	1
NATIONAL FORMULARY NAME	ISOSOURCE LIQUID
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	NUTRITION SUPL ISOSOURCE/VANILLA LIQUID
VA PRODUCT IDENTIFIER	I0352
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	250ML CAN
MASTER ENTRY FOR VUID	YES
VUID	4009885
EFFECTIVE DATE/TIME	2003-08-12 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE