MICROGESTIN 24 FE 1/20 TAB,28 (26455) VA PRODUCT (50.68)

Name	Value
NAME	MICROGESTIN 24 FE 1/20 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	MICROGESTIN 24 FE 1/20 TAB 28
VA PRODUCT IDENTIFIER	M1116
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CYCLE
MASTER ENTRY FOR VUID	YES
VUID	4035279
EFFECTIVE DATE/TIME	2016-01-13 00:00:00 STATUS: ACTIVE 2020-01-15 00:00:00 STATUS: INACTIVE 2020-11-23 00:00:00 STATUS: ACTIVE 2021-07-14 00:00:00 STATUS: ACTIVE 2021-11-04 00:00:00 STATUS: ACTIVE