K BICARB 10MEQ/KCL 8MEQ/K CITRATE 2MEQ TAB,EFFERVSC (3005) VA PRODUCT (50.68)

Name	Value
NAME	K BICARB 10MEQ/KCL 8MEQ/K CITRATE 2MEQ TAB,EFFERVSC
VA GENERIC NAME	POTASSIUM BICARBONATE/POTASSIUM CHLORIDE/POTASSIUM CITRATE
DOSAGE FORM	TAB,EFFERVSC
ACTIVE INGREDIENTS	POTASSIUM BICARBONATE STRENGTH: 10 UNITS: MEQ POTASSIUM CITRATE STRENGTH: 2 UNITS: MEQ POTASSIUM CHLORIDE STRENGTH: 8 UNITS: MEQ BETAINE HYDROCHLORIDE STRENGTH: 1.843 UNITS: GM SACCHARIN STRENGTH: 20 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2016-06-15 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	POTASSIUM BICARBONATE/POTASSIUM CHLORIDE/POTASSIUM CITRATE TAB,EFFERVSC
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	K BICARB/KCL/K CITRATE 20MEQ EFFER TAB
VA PRODUCT IDENTIFIER	K0013
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4003580
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE