AL OH 200MG/MG OH 200MG/SIMETHICONE 20MG/5ML LIQUID,360ML (8407) VA PRODUCT (50.68)

Name	Value
NAME	AL OH 200MG/MG OH 200MG/SIMETHICONE 20MG/5ML LIQUID,360ML
VA GENERIC NAME	ALUMINUM HYDROXIDE/MAGNESIUM HYDROXIDE/SIMETHICONE
DOSAGE FORM	LIQUID
ACTIVE INGREDIENTS	ALUMINUM HYDROXIDE STRENGTH: 200 UNITS: MG/5ML SIMETHICONE STRENGTH: 20 UNITS: MG/5ML MAGNESIUM HYDROXIDE STRENGTH: 200 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	19
NATIONAL FORMULARY NAME	ALUMINUM HYDROXIDE/MAGNESIUM HYDROXIDE/SIMETHICONE LIQUID
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/MGOH/SIMTH REG STRENGTH LIQ,360ML
VA PRODUCT IDENTIFIER	A0590
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	BTL
MASTER ENTRY FOR VUID	YES
VUID	4008875
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE