ETHINYL ESTRADIOL/ETONOGESTREL 0.12MG/0.015MG/24HR RING,VAG (30055) VA PRODUCT (50.68)

Name	Value
NAME	ETHINYL ESTRADIOL/ETONOGESTREL 0.12MG/0.015MG/24HR RING,VAG
VA GENERIC NAME	ETHINYL ESTRADIOL/ETONOGESTREL
DOSAGE FORM	RING,VAG
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	ETONOGESTREL STRENGTH: 0.12 UNITS: MG/24HRS ETHINYL ESTRADIOL STRENGTH: 0.015 UNITS: MG/24HRS
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
INACTIVATION DATE	2020-04-22 00:00:00
NATIONAL FORMULARY NAME	ETHINYL ESTRADIOL/ETONOGESTREL RING,VAG
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2020-04-09 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	EE/ETONOGES 0.12MG/0.015MG/24HR VAG RING
VA PRODUCT IDENTIFIER	E0804
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4039294
EFFECTIVE DATE/TIME	2020-04-09 00:00:00 STATUS: ACTIVE 2020-04-22 00:00:00 STATUS: INACTIVE