NEPHRON FA TAB (6988) VA PRODUCT (50.68)

Name	Value
NAME	NEPHRON FA TAB
VA GENERIC NAME	DOCUSATE/MINERALS/MULTIVITAMINS
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	FERROUS FUMARATE STRENGTH: 200 UNITS: MG RIBOFLAVIN STRENGTH: 1.7 UNITS: MG BIOTIN STRENGTH: 300 UNITS: MCG PYRIDOXINE STRENGTH: 10 UNITS: MG PANTOTHENIC ACID STRENGTH: 10 UNITS: MG DOCUSATE SODIUM STRENGTH: 75 UNITS: MG COBALAMIN STRENGTH: 8 UNITS: MCG ASCORBIC ACID STRENGTH: 40 UNITS: MG THIAMINE STRENGTH: 2.5 UNITS: MG FOLIC ACID STRENGTH: 1 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2020-01-15 00:00:00
DSS NUMBER	3
NATIONAL FORMULARY NAME	DOCUSATE/MINERALS/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	NEPHRON FA TAB
VA PRODUCT IDENTIFIER	N0284
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4007500
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2020-01-15 00:00:00 STATUS: INACTIVE