PROSTATE 2.1 CAP/TAB (17159) VA PRODUCT (50.68)

Name	Value
NAME	PROSTATE 2.1 CAP/TAB
VA GENERIC NAME	MULTIVITAMINS
DOSAGE FORM	CAP/TAB
ACTIVE INGREDIENTS	VITAMIN D STRENGTH: 800 UNITS: UNIT VITAMIN E STRENGTH: 100 UNITS: UNIT SELENIUM STRENGTH: 200 UNITS: MCG SOY LECITHIN STRENGTH: 50 UNITS: MG LYCOPENE STRENGTH: 30 UNITS: MG
NATIONAL FORMULARY NAME	MULTIVITAMINS CAP/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
VA PRINT NAME	PROSTATE 2.1 CAP/TAB
VA PRODUCT IDENTIFIER	P0722
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CAP/TAB
MASTER ENTRY FOR VUID	YES
VUID	4024591
EFFECTIVE DATE/TIME	2006-01-24 00:00:00 STATUS: ACTIVE