AL OH 400MG/MG OH 400MG/SIMETHICONE 40MG/5ML LIQUID(780ML) (17812) VA PRODUCT (50.68)

Name	Value
NAME	AL OH 400MG/MG OH 400MG/SIMETHICONE 40MG/5ML LIQUID(780ML)
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
INACTIVATION DATE	2012-10-03 00:00:00
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	A1192
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	780ML
MASTER ENTRY FOR VUID	YES
VUID	4025424
EFFECTIVE DATE/TIME	2006-07-20 00:00:00 STATUS: ACTIVE 2012-10-03 00:00:00 STATUS: INACTIVE