IRON PS 22MG/IRON HEM POLY 6MG/B12 25MCG/FA 1MG TAB (24661) VA PRODUCT (50.68)

Name	Value
NAME	IRON PS 22MG/IRON HEM POLY 6MG/B12 25MCG/FA 1MG TAB
VA GENERIC NAME	IRON/MULTIVITAMINS
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	IRON (AS POLYSACCHARIDE COMPLEX) STRENGTH: 22 UNITS: MG CYANOCOBALAMIN STRENGTH: 25 UNITS: MCG IRON HEME POLYPEPTIDE STRENGTH: 6 UNITS: MG FOLIC ACID STRENGTH: 1 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2021-08-16 00:00:00
NATIONAL FORMULARY NAME	IRON/MULTIVITAMINS TAB
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	1x Possible Dosage
PACKAGE	Both Inpatient and Outpatient
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	IRON PS 22/IRON POLY 6/B12 25/FA 1MG TAB
VA PRODUCT IDENTIFIER	I0578
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4033270
EFFECTIVE DATE/TIME	2014-04-25 00:00:00 STATUS: ACTIVE 2021-08-16 00:00:00 STATUS: INACTIVE 2021-08-16 00:00:00 STATUS: INACTIVE 2021-08-16 00:00:00 STATUS: INACTIVE