CYANOCOBALAMIN 1MG/FOLIC ACID 2.5MG/PYRIDOXINE 25MG TAB (16566) VA PRODUCT (50.68)

Name	Value
NAME	CYANOCOBALAMIN 1MG/FOLIC ACID 2.5MG/PYRIDOXINE 25MG TAB
VA GENERIC NAME	CYANOCOBALAMIN/FOLIC ACID/PYRIDOXINE
DOSAGE FORM	TAB
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	PYRIDOXINE STRENGTH: 25 UNITS: MG CYANOCOBALAMIN STRENGTH: 1 UNITS: MG FOLIC ACID STRENGTH: 2.5 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
NATIONAL FORMULARY NAME	CYANOCOBALAMIN/FOLIC ACID/PYRIDOXINE 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: 2018-06-14 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	CYANOCOBALAMIN 1/FA 2.5/PYRIDOX 25MG TAB
VA PRODUCT IDENTIFIER	C1132
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4016929
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2006-03-06 00:00:00 STATUS: INACTIVE 2007-10-10 00:00:00 STATUS: ACTIVE 2007-09-28 00:00:00 STATUS: INACTIVE