CHROMAGEN FORTE CAP,UD (1286) VA PRODUCT (50.68)

Name	Value
NAME	CHROMAGEN FORTE CAP,UD
VA GENERIC NAME	MINERALS/MULTIVITAMINS
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	FERROUS FUMARATE STRENGTH: 450 UNITS: MG ASCORBIC ACID STRENGTH: 60 UNITS: MG FOLIC ACID STRENGTH: 1 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	143
NATIONAL FORMULARY NAME	MINERALS/MULTIVITAMINS CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00 COPAY END DATE: 2018-06-14 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2018-06-15 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	CHROMAGEN FORTE CAP UD
VA PRODUCT IDENTIFIER	C0787
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4001887
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE