SIMPESSE 30MCG/0.15MG TAB,EC,91 (29331) VA PRODUCT (50.68)

Name	Value
NAME	SIMPESSE 30MCG/0.15MG TAB,EC,91
VA GENERIC NAME	ETHINYL ESTRADIOL/LEVONORGESTREL
DOSAGE FORM	TAB,ORAL
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	ETHINYL ESTRADIOL STRENGTH: 30 UNITS: MCG LEVONORGESTREL STRENGTH: 0.15 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
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: 2019-06-21 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	SIMPESSE 30MCG/0.15MG EC TAB 91
VA PRODUCT IDENTIFIER	S0878
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CYCLE
MASTER ENTRY FOR VUID	YES
VUID	4038484
EFFECTIVE DATE/TIME	2019-06-21 00:00:00 STATUS: ACTIVE 2019-06-21 00:00:00 STATUS: ACTIVE