MULTIVITAMINS/MINERALS,PRENATAL/DHA CAP (22158) VA PRODUCT (50.68)

Name	Value
NAME	MULTIVITAMINS/MINERALS,PRENATAL/DHA CAP
VA GENERIC NAME	MULTIVITAMIN W/MINERALS
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	CALCIUM (AS CALCIUM CARBONATE) FERROUS FUMARATE VITAMIN E PYRIDOXINE CHOLECALCIFEROL DOCOSAHEXAENOIC ACID MAGNESIUM (AS OXIDE) CYANOCOBALAMIN ASCORBIC ACID FOLIC ACID
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	MULTIVITAMIN W/MINERALS CAP,ORAL
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	MULTIVITAMINS/MINERALS,PRENATAL/DHA CAP
VA PRODUCT IDENTIFIER	M0931
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4030410
EFFECTIVE DATE/TIME	2011-02-09 00:00:00 STATUS: ACTIVE