AL OH 400MG/MG OH 400MG/SIMETHICONE 40MG/5ML LIQUID(360ML) (17811) VA PRODUCT (50.68)

Name	Value
NAME	AL OH 400MG/MG OH 400MG/SIMETHICONE 40MG/5ML LIQUID(360ML)
VA GENERIC NAME	ALUMINUM HYDROXIDE/MAGNESIUM HYDROXIDE/SIMETHICONE
DOSAGE FORM	SUSP,ORAL
ACTIVE INGREDIENTS	ALUMINUM HYDROXIDE STRENGTH: 400 UNITS: MG/5ML SIMETHICONE STRENGTH: 40 UNITS: MG/5ML MAGNESIUM HYDROXIDE STRENGTH: 400 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	ALUMINUM HYDROXIDE/MAGNESIUM HYDROXIDE/SIMETHICONE SUSP,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	ALOH/MGOH/SIMTH XTRA STRENGTH SUSP
VA PRODUCT IDENTIFIER	A1173
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	360ML
MASTER ENTRY FOR VUID	YES
VUID	4025423
EFFECTIVE DATE/TIME	2006-07-20 00:00:00 STATUS: ACTIVE 2010-03-15 00:00:00 STATUS: INACTIVE 2010-05-12 00:00:00 STATUS: ACTIVE