VIT B/VIT C 75MG/FE FUMARATE 110MG/FA 0.5MG/INTRINSIC FACTOR CAP (2194) VA PRODUCT (50.68)

Name	Value
NAME	VIT B/VIT C 75MG/FE FUMARATE 110MG/FA 0.5MG/INTRINSIC FACTOR CAP
VA GENERIC NAME	INTRINSIC FACTOR/IRON/MULTIVITAMINS
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	IRON (AS FERROUS FUMARATE) STRENGTH: 110 UNITS: MG COBALAMIN STRENGTH: 15 UNITS: MCG INTRINSIC FACTOR STRENGTH: 240 UNITS: MG ASCORBIC ACID STRENGTH: 75 UNITS: MG FOLIC ACID STRENGTH: 0.5 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	3
NATIONAL FORMULARY NAME	INTRINSIC FACTOR/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	VIT B/VIT C/FE FUM 110/FA 0.5MG CAP
VA PRODUCT IDENTIFIER	V0201
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4002777
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE