ANNOVERA 0.15MG/0.013MG/24HR RING,VAG (29422) VA PRODUCT (50.68)

Name	Value
NAME	ANNOVERA 0.15MG/0.013MG/24HR RING,VAG
VA GENERIC NAME	ETHINYL ESTRADIOL/SEGESTERONE
DOSAGE FORM	RING,VAG
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	SEGESTERONE ACETATE STRENGTH: 0.15 UNITS: MG/24HRS ETHINYL ESTRADIOL STRENGTH: 0.013 UNITS: MG/24HRS
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	ETHINYL ESTRADIOL/SEGESTERONE RING,VAG
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2019-07-25 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	ANNOVERA 0.15MG/0.013MG/24HR VAG RING
VA PRODUCT IDENTIFIER	A2026
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4038583
EFFECTIVE DATE/TIME	2019-07-25 00:00:00 STATUS: ACTIVE 2019-07-25 00:00:00 STATUS: ACTIVE