AL OH 100MG/MG TRISILICATE 150MG/PHENYLBUTAZONE 100MG CAP (9602) VA PRODUCT (50.68)

Name	Value
NAME	AL OH 100MG/MG TRISILICATE 150MG/PHENYLBUTAZONE 100MG CAP
VA GENERIC NAME	ALUMINUM HYDROXIDE/MAGNESIUM TRISILICATE/PHENYLBUTAZONE
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	MAGNESIUM TRISILICATE STRENGTH: 150 UNITS: MG ALUMINUM HYDROXIDE GEL,DRIED STRENGTH: 100 UNITS: MG PHENYLBUTAZONE STRENGTH: 100 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2002-12-06 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	ALUMINUM HYDROXIDE/MAGNESIUM TRISILICATE/PHENYLBUTAZONE CAP,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	PHENYLBUTAZONE 100MG BUFFERED CAP
VA PRODUCT IDENTIFIER	A0080
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4010017
EFFECTIVE DATE/TIME	2002-12-06 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE