BLISOVI 24 FE TAB,28 (26401) VA PRODUCT (50.68)

Name	Value
NAME	BLISOVI 24 FE TAB,28
VA GENERIC NAME	ETHINYL ESTRADIOL/FERROUS FUMARATE/NORETHINDRONE
DOSAGE FORM	TAB
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	NORETHINDRONE STRENGTH: 1 UNITS: MG FERROUS FUMARATE STRENGTH: 75 UNITS: MG ETHINYL ESTRADIOL STRENGTH: 20 UNITS: MCG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	ETHINYL ESTRADIOL/FERROUS FUMARATE/NORETHINDRONE 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	BLISOVI 24 FE TAB,28
VA PRODUCT IDENTIFIER	B0791
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CYCLE
MASTER ENTRY FOR VUID	YES
VUID	4035218
EFFECTIVE DATE/TIME	2015-12-17 00:00:00 STATUS: ACTIVE