| NAME |
CYANOCOBALAMIN 25MCG/FOLIC ACID 1MG/IRON 150MG CAP |
| VA GENERIC NAME |
CYANOCOBALAMIN/FOLIC ACID/IRON |
| DOSAGE FORM |
CAP,ORAL |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| DSS NUMBER |
1 |
| NATIONAL FORMULARY NAME |
CYANOCOBALAMIN/FOLIC ACID/IRON CAP,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| 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 |
CYANOCOBALAMIN 25MCG/FA 1MG/FE 150MG CAP |
| VA PRODUCT IDENTIFIER |
C1371 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
CAP |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4006942 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
|
