MULTIVITAMINS W/IRON TAB (4813) VA PRODUCT (50.68)

Name	Value
NAME	MULTIVITAMINS W/IRON TAB
VA GENERIC NAME	IRON/MULTIVITAMINS
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	VITAMIN K STRENGTH: 50 UNITS: MCG RIBOFLAVIN STRENGTH: 1.7 UNITS: MG BIOTIN STRENGTH: 30 UNITS: MCG VITAMIN A STRENGTH: 5000 UNITS: UNIT VITAMIN D STRENGTH: 400 UNITS: UNIT IRON STRENGTH: 18 UNITS: MG VITAMIN E STRENGTH: 30 UNITS: UNIT NIACIN STRENGTH: 20 UNITS: MG PANTOTHENIC ACID STRENGTH: 10 UNITS: MG CYANOCOBALAMIN STRENGTH: 6 UNITS: MCG PHYTONADIONE ASCORBIC ACID STRENGTH: 60 UNITS: MG THIAMINE STRENGTH: 1.5 UNITS: MG PYRIDOXINE HYDROCHLORIDE STRENGTH: 2 UNITS: MG FOLIC ACID STRENGTH: 0.4 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	42
NATIONAL FORMULARY NAME	IRON/MULTIVITAMINS TAB
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00 COPAY END DATE: 2018-06-14 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2018-06-15 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	MULTIVITAMIN/IRON CAP/TAB
VA PRODUCT IDENTIFIER	V0021
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CAP/TAB
MASTER ENTRY FOR VUID	YES
VUID	4005359
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE