FA 1MG/IRON (FEFM-FEPOL)106MG/MULTIVITAMINS CAP (20939) VA PRODUCT (50.68)

Name	Value
NAME	FA 1MG/IRON (FEFM-FEPOL)106MG/MULTIVITAMINS CAP
VA GENERIC NAME	FOLIC ACID/IRON/MULTIVITAMINS
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	FERROUS FUMARATE STRENGTH: 162 UNITS: MG PANTOTHENIC ACID IRON POLYSACCHARIDE COMPLEX STRENGTH: 115.2 UNITS: MG FOLIC ACID STRENGTH: 1 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	FOLIC ACID/IRON/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	FA 1/IRON (FEFM-FEPOL)106MG/MULTIVIT CAP
VA PRODUCT IDENTIFIER	F0449
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4029019
EFFECTIVE DATE/TIME	2009-09-09 00:00:00 STATUS: ACTIVE