| NAME |
CITRIC ACID 12GM/MAGNESIUM OXIDE 3.5GM/NA PICOSULFATE 10MG/175ML |
| VA GENERIC NAME |
CITRIC ACID/MAGNESIUM OXIDE/SODIUM PICOSULFATE |
| DOSAGE FORM |
SOLN,ORAL |
| FDA MED GUIDE |
Citrate_MgOxide_NaPicosulfate_(Clenpiq)_(2022).pdf |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
CITRIC ACID/MAGNESIUM OXIDE/SODIUM PICOSULFATE SOLN,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2023-03-09 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
CITRIC AC/MAG OX/NA PICOS(CLENPIQ) 175ML |
| VA PRODUCT IDENTIFIER |
C2056 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
BTL |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042087 |
| EFFECTIVE DATE/TIME |
-
- 2023-03-09 00:00:00
- STATUS: ACTIVE
|
