NEPHRO-VITE RX TAB (1569) VA PRODUCT (50.68)

Name	Value
NAME	NEPHRO-VITE RX TAB
VA GENERIC NAME	MULTIVITAMINS
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	CALCIUM PANTOTHENATE STRENGTH: 5 UNITS: MG RIBOFLAVIN STRENGTH: 1.7 UNITS: MG BIOTIN STRENGTH: 300 UNITS: MCG PYRIDOXINE STRENGTH: 10 UNITS: MG MAGNESIUM CYANOCOBALAMIN STRENGTH: 6 UNITS: MCG ASCORBIC ACID STRENGTH: 60 UNITS: MG THIAMINE STRENGTH: 1.5 UNITS: MG FOLIC ACID STRENGTH: 1 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	114
NATIONAL FORMULARY NAME	MULTIVITAMINS 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 COPAY END DATE: 2018-01-31 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2018-02-01 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	NEPHRO-VITE RX TAB
VA PRODUCT IDENTIFIER	N0231
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4002162
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE