ETHINYL ESTRADIOL 0.05MG/ETHYNODIOL DIACETATE 1MG TAB (3033) VA PRODUCT (50.68)

Name	Value
NAME	ETHINYL ESTRADIOL 0.05MG/ETHYNODIOL DIACETATE 1MG TAB
VA GENERIC NAME	ETHINYL ESTRADIOL/ETHYNODIOL DIACETATE
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	ETHINYL ESTRADIOL STRENGTH: 0.05 UNITS: MG ETHYNODIOL DIACETATE STRENGTH: 1 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	1
NATIONAL FORMULARY NAME	ETHINYL ESTRADIOL/ETHYNODIOL DIACETATE TAB
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4003608
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE