ETHINYL ESTRADIOL/NORETHINDRONE FE(EQV-LOESTRIN FE 1.5/30)TAB,28 (31897) VA PRODUCT (50.68)

Name	Value
NAME	ETHINYL ESTRADIOL/NORETHINDRONE FE(EQV-LOESTRIN FE 1.5/30)TAB,28
VA GENERIC NAME	ETHINYL ESTRADIOL/FERROUS FUMARATE/NORETHINDRONE
DOSAGE FORM	TAB
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	NORETHINDRONE ACETATE STRENGTH: 1.5 UNITS: MG FERROUS FUMARATE STRENGTH: 75 UNITS: MG ETHINYL ESTRADIOL STRENGTH: 0.03 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	ETHINYL ESTRADIOL/FERROUS FUMARATE/NORETHINDRONE TAB
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2022-04-15 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	EE/NORETH FE(EQV-LOESTRIN FE 1.5/30),28
VA PRODUCT IDENTIFIER	E0853
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CYCLE
MASTER ENTRY FOR VUID	YES
VUID	4041347
EFFECTIVE DATE/TIME	2022-04-18 00:00:00 STATUS: ACTIVE