PREMPHASE TAB,28 PACK (12345) VA PRODUCT (50.68)

Name	Value
NAME	PREMPHASE TAB,28 PACK
VA GENERIC NAME	ESTROGENS/MEDROXYPROGESTERONE
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	ESTROGENS,CONJUGATED STRENGTH: DAY1-28 X 0.625 UNITS: MG MEDROXYPROGESTERONE ACETATE STRENGTH: DAY15-28 X 5 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	3
NATIONAL FORMULARY NAME	ESTROGENS/MEDROXYPROGESTERONE TAB
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	PREMPHASE TAB,28 PACK
VA PRODUCT IDENTIFIER	P0413
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CYCLE
MASTER ENTRY FOR VUID	YES
VUID	4012711
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE