MATERNA PRENATAL TAB (1190) VA PRODUCT (50.68)

Name	Value
NAME	MATERNA PRENATAL TAB
VA GENERIC NAME	MINERALS/MULTIVITAMINS
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	SUCROSE RIBOFLAVIN STRENGTH: 3.4 UNITS: MG BIOTIN STRENGTH: 30 UNITS: MCG VITAMIN A STRENGTH: 5000 UNITS: IU VITAMIN D STRENGTH: 400 UNITS: IU CALCIUM STRENGTH: 250 UNITS: MG IRON STRENGTH: 60 UNITS: MG ZINC STRENGTH: 25 UNITS: MG COPPER IODINE MAGNESIUM PANTOTHENIC ACID STRENGTH: 10 UNITS: MG MOLYBDENUM MANGANESE CHROMIUM CYANOCOBALAMIN STRENGTH: 12 UNITS: MCG ASCORBIC ACID STRENGTH: 100 UNITS: MG THIAMINE STRENGTH: 3 UNITS: MG PYRIDOXINE HYDROCHLORIDE STRENGTH: 10 UNITS: MG FOLIC ACID STRENGTH: 1 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2010-11-03 00:00:00
DSS NUMBER	47
NATIONAL FORMULARY NAME	MINERALS/MULTIVITAMINS TAB
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	MATERNA PRENATAL TAB
VA PRODUCT IDENTIFIER	M0720
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4001792
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2010-11-03 00:00:00 STATUS: INACTIVE