EVAC-Q-MAG 300ML/EVAC-Q-SERT SUPP #2/EVAC-Q-TAB 130MG #2 KIT (9674) VA PRODUCT (50.68)

Name	Value
NAME	EVAC-Q-MAG 300ML/EVAC-Q-SERT SUPP #2/EVAC-Q-TAB 130MG #2 KIT
VA GENERIC NAME	MAGNESIUM CITRATE/PHENOLPHTHALEIN/POTASSIUM BITARTRATE/SODIUM BI
DOSAGE FORM	KIT
ACTIVE INGREDIENTS	POTASSIUM CITRATE PHENOLPHTHALEIN STRENGTH: TAB UNITS: 130 MG X 2 MAGNESIUM CITRATE STRENGTH: 300 UNITS: ML EVAC-Q-SERT STRENGTH: SUPP UNITS: X 2 CITRIC ACID
CS FEDERAL SCHEDULE	Unscheduled
DSS NUMBER	1
NATIONAL FORMULARY NAME	MAGNESIUM CITRATE/PHENOLPHTHALEIN/POTASSIUM BITARTRATE/SODIUM BI KIT
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	EVAC-Q-KIT
VA PRODUCT IDENTIFIER	E0160
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4010083
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE