CITRIC ACID 12GM/MAGNESIUM OXIDE 3.5GM/NA PICOSULFATE 10MG/160ML (28210) VA PRODUCT (50.68)

Name	Value
NAME	CITRIC ACID 12GM/MAGNESIUM OXIDE 3.5GM/NA PICOSULFATE 10MG/160ML
VA GENERIC NAME	CITRIC ACID/MAGNESIUM OXIDE/SODIUM PICOSULFATE
DOSAGE FORM	SOLN,ORAL
FDA MED GUIDE	Citrate_MgOxide_NaPicosulfate_(Clenpiq)_(2022).pdf
ACTIVE INGREDIENTS	MAGNESIUM OXIDE STRENGTH: 3.5 UNITS: GM/BTL SODIUM PICOSULFATE STRENGTH: 10 UNITS: MG/BTL CITRIC ACID STRENGTH: 12 UNITS: GM/BTL
NATIONAL FORMULARY NAME	CITRIC ACID/MAGNESIUM OXIDE/SODIUM PICOSULFATE SOLN,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2018-03-01 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	CITRIC AC/MAG OX/NA PICOS(CLENPIQ) 160ML
VA PRODUCT IDENTIFIER	C1846
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	BTL
MASTER ENTRY FOR VUID	YES
VUID	4037198
EFFECTIVE DATE/TIME	2018-01-05 00:00:00 STATUS: ACTIVE