CHOLECALCIFEROL 5000 UNITS/FOLIC ACID 1MG TAB (26241)    VA PRODUCT (50.68)

Name Value
NAME CHOLECALCIFEROL 5000 UNITS/FOLIC ACID 1MG TAB
VA GENERIC NAME CHOLECALCIFEROL/FOLIC ACID
DOSAGE FORM TAB,ORAL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME CHOLECALCIFEROL/FOLIC ACID TAB,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:   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 CHOLECALCIFEROL 5000 UNITS/FOLIC 1MG TAB
VA PRODUCT IDENTIFIER C1740
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4035039
EFFECTIVE DATE/TIME
  • 2015-11-17 00:00:00
    STATUS:   ACTIVE