Product Details

Diovol EX

Aluminum Hydroxide + Magnesium Hydroxide
120 mg + 60 mg/mL
Oral Liquid

DIN/PIN/NPN

00491217

Manufacturer

Frank W. Horner Inc.

Formulary Listing Date

1996-10-01

Unit Price

NA

Amount MOH Pays

NA

Coverage Status

Not a Benefit Designated Pharmaceutical Product

ODB Formulary Therapeutic Classification

56:04:00 Antacids and Adsorbents

Therapeutic Note

NO

ATC Code

#

Interchangeable Products

DIN/ PIN/ NPN	Brand name	Unit Price	Amount MOH pays
02162369	Maalox TC	NA	NA
00491217	Diovol EX	NA	NA

LU Clinical Criteria

NO

EAP Criteria

NO

Product Monograph