AL OH 31.5MG/MG CARB 137.5/NA ALGINATE 136MG/5ML LIQUID (8126) VA PRODUCT (50.68)

Name	Value
NAME	AL OH 31.5MG/MG CARB 137.5/NA ALGINATE 136MG/5ML LIQUID
VA GENERIC NAME	ALUMINUM HYDROXIDE/MAGNESIUM CARBONATE/SODIUM ALGINATE
DOSAGE FORM	SUSP,ORAL
ACTIVE INGREDIENTS	ALUMINUM HYDROXIDE STRENGTH: 31.5 UNITS: MG/5ML SODIUM ALGINATE STRENGTH: 136 UNITS: MG/5ML MAGNESIUM CARBONATE STRENGTH: 137.5 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2004-11-18 00:00:00
DSS NUMBER	3
NATIONAL FORMULARY NAME	ALUMINUM HYDROXIDE/MAGNESIUM CARBONATE/SODIUM ALGINATE SUSP,ORAL
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	ALOH/MG CARB/NA ALGINATE 140MG/5ML LIQ
VA PRODUCT IDENTIFIER	A0504
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	360ML
MASTER ENTRY FOR VUID	NO
VUID	4008601
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2005-12-08 00:00:00 STATUS: ACTIVE 2010-09-21 00:00:00 STATUS: INACTIVE 2004-11-18 00:00:00 STATUS: INACTIVE