AMETHIA LO 20MCG/0.1MG TAB,91 (26616)    VA PRODUCT (50.68)

Name Value
NAME AMETHIA LO 20MCG/0.1MG TAB,91
VA GENERIC NAME ETHINYL ESTRADIOL/LEVONORGESTREL
DOSAGE FORM TAB,ORAL
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2021-04-15 00:00:00
NATIONAL FORMULARY NAME ETHINYL ESTRADIOL/LEVONORGESTREL TAB,ORAL
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 AMETHIA LO 20MCG/0.1MG TAB 91
VA PRODUCT IDENTIFIER A1878
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CYCLE
MASTER ENTRY FOR VUID YES
VUID 4035451
EFFECTIVE DATE/TIME
  • 2016-03-01 00:00:00
    STATUS:   ACTIVE
  • 2021-04-15 00:00:00
    STATUS:   INACTIVE
  • 2021-04-15 00:00:00
    STATUS:   INACTIVE
  • 2021-04-15 00:00:00
    STATUS:   INACTIVE