MAGNESIUM SO4/POTASSIUM SO4/SODIUM SO4 SOLN,ORAL,KIT (21952) VA PRODUCT (50.68)

Name	Value
NAME	MAGNESIUM SO4/POTASSIUM SO4/SODIUM SO4 SOLN,ORAL,KIT
VA GENERIC NAME	MAGNESIUM SULFATE/POTASSIUM SULFATE/SODIUM SULFATE
DOSAGE FORM	SOLN,ORAL
FDA MED GUIDE	Mag_Pot_Sod_Sulfate_Liq_(Suprep)_(2020).pdf
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	SODIUM SULFATE STRENGTH: 97.2 UNITS: MG/ML POTASSIUM SULFATE STRENGTH: 17.4 UNITS: MG/ML MAGNESIUM SULFATE STRENGTH: 8.9 UNITS: MG/ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	MAGNESIUM SULFATE/POTASSIUM SULFATE/SODIUM SULFATE SOLN,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00 COPAY END DATE: 2022-07-20 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2022-07-21 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	COLON ELECTROLYTE LAVAGE ORAL SOLN KIT
VA PRODUCT IDENTIFIER	M0916
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	KIT
MASTER ENTRY FOR VUID	YES
VUID	4030165
EFFECTIVE DATE/TIME	2010-10-13 00:00:00 STATUS: ACTIVE