SAFYRAL TAB,28 (22501)    VA PRODUCT (50.68)

Name Value
NAME SAFYRAL TAB,28
VA GENERIC NAME DROSPIRENONE/ETHINYL ESTRADIOL/LEVOMEFOLATE
DOSAGE FORM TAB
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME DROSPIRENONE/ETHINYL ESTRADIOL/LEVOMEFOLATE 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 SAFYRAL TAB,28
VA PRODUCT IDENTIFIER S0667
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CYCLE
MASTER ENTRY FOR VUID YES
VUID 4030794
EFFECTIVE DATE/TIME
  • 2011-07-12 00:00:00
    STATUS:   ACTIVE