MAXEPA FISH OIL CONCENTRATE CAP (9185) VA PRODUCT (50.68)

Name	Value
NAME	MAXEPA FISH OIL CONCENTRATE CAP
VA GENERIC NAME	DOCOSAHEXAENOIC ACID/EICOSAPENTAENOIC ACID/OMEGA-3 POLYUNSATURAT
DOSAGE FORM	CAP,ORAL
ACTIVE INGREDIENTS	DOCOSAHEXAENOIC ACID STRENGTH: 120 UNITS: MG/GM EICOSAPENTAENOIC ACID STRENGTH: 180 UNITS: MG OMEGA-3 POLYUNSATURATES
CS FEDERAL SCHEDULE	Unscheduled
STRENGTH	1000
SINGLE/MULTI SOURCE PRODUCT	Single source
UNITS	MG
DSS NUMBER	1
NATIONAL FORMULARY NAME	DOCOSAHEXAENOIC ACID/EICOSAPENTAENOIC ACID/OMEGA-3 POLYUNSATURAT CAP,ORAL
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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4009615
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE