CITRIC ACID 12GM/MAGNESIUM OXIDE 3.5GM/NA PICOSULFATE 10MG PKT (23816)    VA PRODUCT (50.68)

Name Value
NAME CITRIC ACID 12GM/MAGNESIUM OXIDE 3.5GM/NA PICOSULFATE 10MG PKT
VA GENERIC NAME CITRIC ACID/MAGNESIUM OXIDE/SODIUM PICOSULFATE
DOSAGE FORM POWDER,ORAL
FDA MED GUIDE Citrate_MgOxide_NaPicosulfate_(Prepopik)_(2018).pdf
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2021-03-15 00:00:00
NATIONAL FORMULARY NAME CITRIC ACID/MAGNESIUM OXIDE/SODIUM PICOSULFATE POWDER,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:   2021-02-03 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2021-02-04 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME CITRIC AC/MAG OX/NA PICOS (PREPOPIK) PKT
VA PRODUCT IDENTIFIER C1565
TRANSMIT TO CMOP YES
VA DISPENSE UNIT PKT
MASTER ENTRY FOR VUID YES
VUID 4032317
EFFECTIVE DATE/TIME
  • 2013-04-17 00:00:00
    STATUS:   ACTIVE
  • 2021-03-15 00:00:00
    STATUS:   INACTIVE
  • 2021-03-15 00:00:00
    STATUS:   INACTIVE
  • 2021-03-15 00:00:00
    STATUS:   INACTIVE