CITRIC ACID/SIMETHICONE/NA BICARB/PKT GRANULES (22691) VA PRODUCT (50.68)

Name	Value
NAME	CITRIC ACID/SIMETHICONE/NA BICARB/PKT GRANULES
VA GENERIC NAME	CITRIC ACID/SIMETHICONE/SODIUM BICARBONATE
DOSAGE FORM	GRNL,EFFERVSC
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	SIMETHICONE STRENGTH: 4000 UNITS: MG CITRIC ACID STRENGTH: 1530 UNITS: MG SODIUM BICARBONATE STRENGTH: 2210 UNITS: MG
NATIONAL FORMULARY NAME	CITRIC ACID/SIMETHICONE/SODIUM BICARBONATE GRNL,EFFERVSC
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	E-Z GAS II GRANULES
VA PRODUCT IDENTIFIER	C1492
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	PKT
MASTER ENTRY FOR VUID	YES
VUID	4031026
EFFECTIVE DATE/TIME	2011-10-11 00:00:00 STATUS: ACTIVE