RAJANI TAB,28 (29301) VA PRODUCT (50.68)

Name	Value
NAME	RAJANI TAB,28
VA GENERIC NAME	DROSPIRENONE/ETHINYL ESTRADIOL/LEVOMEFOLATE
DOSAGE FORM	TAB
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	DROSPIRENONE STRENGTH: 3 UNITS: MG LEVOMEFOLATE CALCIUM STRENGTH: 0.451 UNITS: MG ETHINYL ESTRADIOL STRENGTH: 0.02 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2020-01-15 00:00:00
NATIONAL FORMULARY NAME	DROSPIRENONE/ETHINYL ESTRADIOL/LEVOMEFOLATE TAB
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2019-06-07 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	RAJANI TAB,28
VA PRODUCT IDENTIFIER	R0392
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CYCLE
MASTER ENTRY FOR VUID	YES
VUID	4038450
EFFECTIVE DATE/TIME	2019-06-07 00:00:00 STATUS: ACTIVE 2020-01-15 00:00:00 STATUS: INACTIVE