CHOLECALCIFEROL 3775 UNITS/FOLIC ACID 1MG CAP,ORAL (25591) VA PRODUCT (50.68)

Name	Value
NAME	CHOLECALCIFEROL 3775 UNITS/FOLIC ACID 1MG CAP,ORAL
VA GENERIC NAME	CHOLECALCIFEROL/FOLIC ACID
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	CHOLECALCIFEROL STRENGTH: 3775 UNITS: UNIT FOLIC ACID STRENGTH: 1 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	CHOLECALCIFEROL/FOLIC ACID CAP,ORAL
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: 2017-05-31 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-06-01 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	CHOLECALCIFEROL 3775 UNITS/FOLIC 1MG CAP
VA PRODUCT IDENTIFIER	C1698
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4034324
EFFECTIVE DATE/TIME	2015-03-30 00:00:00 STATUS: ACTIVE