SIMLIYA TAB,28 (29236) VA PRODUCT (50.68)

Name	Value
NAME	SIMLIYA TAB,28
VA GENERIC NAME	DESOGESTREL/ETHINYL ESTRADIOL
DOSAGE FORM	TAB
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	DESOGESTREL STRENGTH: 0.15 UNITS: MG ETHINYL ESTRADIOL STRENGTH: 0.02-0.01 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	DESOGESTREL/ETHINYL ESTRADIOL TAB
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2019-05-16 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	SIMLIYA TAB,28
VA PRODUCT IDENTIFIER	S0875
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CYCLE
MASTER ENTRY FOR VUID	YES
VUID	4038374
EFFECTIVE DATE/TIME	2019-05-16 00:00:00 STATUS: ACTIVE