CHOLECALCIFEROL 1250MCG/PHYTONADIONE 200MCG CAP,ORAL (31563) VA PRODUCT (50.68)

Name	Value
NAME	CHOLECALCIFEROL 1250MCG/PHYTONADIONE 200MCG CAP,ORAL
VA GENERIC NAME	CHOLECALCIFEROL/PHYTONADIONE
DOSAGE FORM	CAP,ORAL
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	CHOLECALCIFEROL STRENGTH: 1250 UNITS: MCG PHYTONADIONE STRENGTH: 200 UNITS: MCG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	CHOLECALCIFEROL/PHYTONADIONE CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	1x Possible Dosage
PACKAGE	Both Inpatient and Outpatient
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2021-11-18 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	CHOLECAL 1250MCG/PHYTONADIONE 200MCG CAP
VA PRODUCT IDENTIFIER	C2011
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4040966
EFFECTIVE DATE/TIME	2021-11-18 00:00:00 STATUS: ACTIVE