TRIPHASIL TAB,28 (2623) VA PRODUCT (50.68)

Name	Value
NAME	TRIPHASIL TAB,28
VA GENERIC NAME	ETHINYL ESTRADIOL/LEVONORGESTREL
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	ETHINYL ESTRADIOL STRENGTH: 0.03-0.04 UNITS: MG LEVONORGESTREL STRENGTH: 0.05-0.125 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2010-05-05 00:00:00
DSS NUMBER	7
NATIONAL FORMULARY NAME	ETHINYL ESTRADIOL/LEVONORGESTREL 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	TRIPHASIL TAB,28
VA PRODUCT IDENTIFIER	T0249
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CYCLE
MASTER ENTRY FOR VUID	YES
VUID	4003204
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2010-05-05 00:00:00 STATUS: INACTIVE