FOLIC ACID 1MG/IRON HEME POLYPEPTIDE 12MG TAB,ORAL (25732)    VA PRODUCT (50.68)

Name Value
NAME FOLIC ACID 1MG/IRON HEME POLYPEPTIDE 12MG TAB,ORAL
VA GENERIC NAME FOLIC ACID/IRON
DOSAGE FORM TAB
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME FOLIC ACID/IRON 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 FOLIC ACID 1MG/IRON HEME POLYPE 12MG TAB
VA PRODUCT IDENTIFIER F0566
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4034482
EFFECTIVE DATE/TIME
  • 2015-05-28 00:00:00
    STATUS:   ACTIVE