TRIPLE VITAMINS W/FLUORIDE 1MG TAB (1667) VA PRODUCT (50.68)

Name	Value
NAME	TRIPLE VITAMINS W/FLUORIDE 1MG TAB
VA GENERIC NAME	FLUORIDE/MULTIVITAMINS
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	VITAMIN A STRENGTH: 2500 UNITS: UNIT VITAMIN D STRENGTH: 400 UNITS: UNIT FLUORIDE STRENGTH: 1 UNITS: MG ASCORBIC ACID STRENGTH: 60 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-28 00:00:00
DSS NUMBER	24
NATIONAL FORMULARY NAME	FLUORIDE/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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4002253
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-28 00:00:00 STATUS: INACTIVE