PRENATE 90 TAB (6987) VA PRODUCT (50.68)

Name	Value
NAME	PRENATE 90 TAB
VA GENERIC NAME	DOCUSATE/MINERALS/MULTIVITAMINS
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	ZINC (AS OXIDE) STRENGTH: 25 UNITS: MG CALCIUM (AS CITRATE) STRENGTH: 200 UNITS: MG NIACINAMIDE STRENGTH: 20 UNITS: MG RIBOFLAVIN STRENGTH: 3.4 UNITS: MG THIAMINE MONONITRATE STRENGTH: 3 UNITS: MG VITAMIN A STRENGTH: 2700 UNITS: UNIT VITAMIN D STRENGTH: 400 UNITS: UNIT IRON STRENGTH: 30 UNITS: MG IODINE STRENGTH: 150 UNITS: MCG DOCUSATE SODIUM STRENGTH: 50 UNITS: MG COPPER (AS CUPRIC OXIDE) STRENGTH: 2 UNITS: MG CYANOCOBALAMIN STRENGTH: 12 UNITS: MCG VITAMIN E ACETATE STRENGTH: 30 UNITS: UNIT ASCORBIC ACID STRENGTH: 120 UNITS: MG PYRIDOXINE HYDROCHLORIDE STRENGTH: 20 UNITS: MG FOLIC ACID STRENGTH: 1 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2008-09-03 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	DOCUSATE/MINERALS/MULTIVITAMINS 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
VA PRINT NAME	PRENATE 90 TAB
VA PRODUCT IDENTIFIER	P0433
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4007499
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2008-09-03 00:00:00 STATUS: INACTIVE