BLISOVI FE 1.5/30 TAB,28 (26470)    VA PRODUCT (50.68)

Name Value
NAME BLISOVI FE 1.5/30 TAB,28
VA GENERIC NAME ETHINYL ESTRADIOL/FERROUS FUMARATE/NORETHINDRONE
DOSAGE FORM TAB
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
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 FE 1.5/30 TAB,28
VA PRODUCT IDENTIFIER B0805
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CYCLE
MASTER ENTRY FOR VUID YES
VUID 4035295
EFFECTIVE DATE/TIME
  • 2016-01-14 00:00:00
    STATUS:   ACTIVE