ELAGOLIX/ESTRADIOL/NORETHINDRONE CAP,ORAL WEEKLY PACK (30192) VA PRODUCT (50.68)

Name	Value
NAME	ELAGOLIX/ESTRADIOL/NORETHINDRONE CAP,ORAL WEEKLY PACK
VA GENERIC NAME	ELAGOLIX/ESTRADIOL/NORETHRINDRONE
DOSAGE FORM	CAP,ORAL
FDA MED GUIDE	Elagolix-Estradiol-Norethindrone_Elagolix_Cap_(Oriahnn)_(2020).pdf
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	NORETHINDRONE STRENGTH: 0.5 UNITS: MG ESTRADIOL STRENGTH: 1 UNITS: MG ELAGOLIX STRENGTH: 300 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	ELAGOLIX/ESTRADIOL/NORETHRINDRONE CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	No Possible Dosages
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2020-06-11 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	ORIAHNN ORAL CAP WEEKLY PACK
VA PRODUCT IDENTIFIER	O0417
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	PKT
MASTER ENTRY FOR VUID	YES
VUID	4039452
EFFECTIVE DATE/TIME	2020-06-11 00:00:00 STATUS: ACTIVE