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[]
[]
[null,null,null,null,null,null,"Standard Pharmaceutical Product and Medical Device Information (Rx Product Only)"]
[null,null,"Version 2021",null,null,null,null,null,null,null,null,null,null,null,"Introduction Type:",null,null,"New Item",null,null,null,null,null,null,null,"x","Final Version",null,null,"Date:","2024-06-03"]
[]
[null,"PRODUCT INFORMATION",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"SPECIAL HANDLING AND STORAGE REQUIREMENTS*"]
[]
[null,null,"Company Name:  ",null,null,"Modavar Pharmaceuticals LLC (U.S. Agent for Cadila Pharmaceuticals Limited)",null,null,null,null,null,null,null,null,null,"Application:",null,null,"ANDA",null,null,null,null,null,"a. Temperature – Indicate the USP temperature range for this product."]
[null,null,null,"Application Number for NDA/ANDA/BLA (drug); PMA/510(k)(med device):",null,null,null,null,null,null,null,"210022",null,null,null,null,null,null,null,null,null,null,null,null,null,"Temperature Range",null,"Controlled Room – between 20 and 25 C (68° – 77° F)"]
[null,null,null,"Medical Device Class, if applicable:"]
[null,null,"DUNS:",null,null,"858949204",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Other Temperature Range Requirement"]
[null,null,"Proprietary Name (If Applicable) and Established Name:  ",null,null,null,null,"Olanzapine7.5mg  Tablets 30's",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"         (write in)"]
[null,null,null,"Selling Unit NDC:",null,"72241-0053-22",null,"Unit of Use NDC:",null,null,null,null,null,null,null,"UPC:",372241053221,null,null,null,null,null,null,null,null,"Notes"]
[null,null,null,null,"UDI",null,null,null,null,"CVX Code:",null,null,null,null,"MVX Code:"]
[]
[null,null,"Description:   ",null,null,"Olanzapine Tablets 7.5mg 30ct ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Is this product to be shipped to customers on ice?",null,null,null,null,"No"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Is this product to be shipped to customers on dry ice? ",null,null,null,null,"No"]
[null,null,null,"Active Ingredient(s):",null,null,"Olanzapine "]
[null,null," ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"b. Contact for temperature excursion questions:"]
[null,null,"URL for Additional Product Information:  ",null,null,null,"www.modavar.com ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Name:",null,null,"ModavarCS@eversana.com "]
[null,null,"Address: ",null,null,"1016 16th Street, NW, Ste. 602",null,null,null,null,null,null,null,"Address 2:",null,null,null,null,null,null,null,null,null,null,null,"Number:",null,null,"800-688-4697"]
[null,null,"City:  ",null,null,"Washington ",null,null,null,null,null,null,"State:",null,"DC",null,"Zip:",null,"20036",null,null,null,null,null,null,"Group E-mail:",null,null,"ModavarCS@eversana.com "]
[null,null,"Key Contact: ",null,null,"Tamara Solomon",null,null,null,null,null,null,"Email:",null,"Tsolomon@modavar.com "]
[null,null,"Phone Number:",null,null,"202-355-9785",null,null,null,null,null,null,"Fax:",null,"(202)355-9784",null,null,null,null,null,null,null,null,null,"c. Special regulations for product in any states?",null,null,null,null,null,"No"]
[null,null,"Product Therapeutic Classification:",null,null,null,"ANTIPSYCHOTIC",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Special returns requirements for this product? ",null,null,null,null,"No"]
[]
[null,null,"ADDITIONAL PRODUCT INFORMATION",null,null,null,null,null,null,null,null,null,null,null,"PRODUCT DESCRIPTION INFORMATION",null,null,null,null,null,null,null,null,null,"d. Store product (unit of sale) upright?",null,null,null,null,null,"No"]
[]
[null,null,null,"The product is?",null,null,null,null,null,"Is the Product…       ","Direct And Drop-Ship",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Protect product (unit of sale) from light? ",null,null,null,null,"No"]
[null,null,null,"  a legend device?",null,null,"No",null,null,"Is the Product…       ","Neither",null,null,null,null,"Size:",null,"30ct",null,null,null,null,null,null,"e. Shelf life:  ",null,null,null,null,null,24,"Months"]
[null,null,null,"  if yes, enter class #",null,null,null,null,null,"Orphan Drug Status",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Initial shelf life at launch (if different):",null,null,null,null,null,"Months"]
[null,null,null,"  a product kit?",null,null,"No",null,null,null,null,null,null,null,null,"Strength:",null,"7.5MG"]
[null,null,null,"  if yes, list NDCs of",null,null,null,null,null,"FDA Approval Status",null,null,null,null,null,null,null,null,null,null,null,null,null,"ORDER INFORMATION"]
[null,null,null,"    component parts",null,null,null,null,null,null,null,null,null,null,null,"Dosage Form:",null,"Tablets "]
[null,null,null,"  reverse numbered?",null,null,"No",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Unit of Sale",null,null,"What is the NDC selling unit?\n"]
[null,null,null,"  co-licensed?",null,null,"No",null,null,"Allergens Present",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"x","Bottle",null,"1 bottle of 30"]
[null,null,null,"  latex-free?",null,null,"Yes",null,null,"See Package Insert -",null,null,null,null,null,"Product Shape:",null,"round, biconvex",null,null,null,null,null,null,null,null,"Box/Carton",null," (Write-in, e.g. 1 Box of 10 Vials)"]
[null,null,null,"  preservative-free?",null,null,"Yes",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Ampule"]
[null,null,null,"  correctional institution block?",null,null,"No",null,null,null,null,null,null,null,null,"Product Color:",null,"White to off-white",null,null,null,null,null,null,null,null,"Glass",null,"Minimum order quantity?",null,null,"Yes"]
[null,null,null,"  opioid?",null,null,"No",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Tube"]
[null,null,null,"  Cannabinoid?",null,null,"No",null,null,"Country of Origin","India ",null,null,null,null,"Product Imprint:",null,"debossed \"C6\" on one side and plain on the other.",null,null,null,null,null,null,null,null,"Vial Liquid Sgl"]
[null,null,null,"If Unit Dose, is item bar coded to unit dose for hospital scanning?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Vial Liquid Multi",null,"If Yes, how many of which package type? "]
[null,null,null,null,null,null,null,null,null,"Is this product covered under the Trade Agreements Act (TAA)?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Vial Powder Sql",null,"x","Each"]
[null,null,null,"If Unit Dose, indicate NDC here: ",null,null,null,null,null,null,null,null,"No",null,null,null,null,null,null,null,null,null,null,null,null,null,"Vial Power Multi",null,null,"Inner/Carton/Pack"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Other: Write In",null,null,"Case"]
[]
[null,"FOR GENERIC DRUG PRODUCTS"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"  Authorized Generic",null,null,"*If Authorized Generic, other section fields are not applicable",null,null,null,null,null,null,"PHARMACY ORDER / BILL UNIT"]
[]
[null,null,"I. Orange Book Rating:",null,null,"AB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Rec. sell unit to customer?\n",null,null,null,"Rx billing unit to pharmacy:"]
[null,null,"II. Generic Equivalent to What Brand?:",null,null,null,"Zyprexa®",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1 pill",null,null,null,"x"," Each"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," (Write-in, e.g. 1 Vial)",null,null,null,null," Gram"]
[null,"DRUG SUPPLY CHAIN SECURITY ACT (DSCSA) INFORMATION",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," Milliliter"]
[]
[null,null,"Does supplier meet DSCSA definition of manufacturer?",null,null,null,null,"Yes",null,null,null,null,"GLN:",null,"0372241000003",null,null,null,null,null,null,null,null,"ITEM AND PACKING INFORMATION"]
[null,null,"Is product exempt from DSCSA?",null,null,null,"No"]
[]
[null,null,null,"If yes, select exemption:",null,null,null,null,null,null,null,null,"GCP:",null,null,null,null,null,null,null,null,null,null,null,null,null,"Weight Lbs.","Dimensions (US msmts.)",null,null,"Volume (Cube) ","Saleable # Pieces"]
[null,null,null,"Other exemption - Write in:",null,null,null,null,null,null,null," ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Depth","Width","Height"]
[null,null,"Is product repackaged? ",null,null,null,"No",null,null,null,null,null,"If yes, was original product purchased direct from mfr? ",null,null,null,null,null,null,null,null,null,null,null,"Item/Each:",null,0.11342783389411952,2.992,2.992,5.7080000000000002,{"$f":"AB61*AC61*AD61","v":51.098381312000001},1]
[null,null,"Is product sold by manufacturer's exclusive distributor?",null,null,null,null,"No"]
[null,null,"Has FDA granted waiver/exception/exemption for product?",null,null,null,null,"No",null,null,null,null,"Provide source manufacturer for repackaged product",null,null,null,null,null,null,null,null,null,null,null,"Box/Carton/Bundle/ Inner Pack:",null,1.5347999999999999,7.4050000000000002,4.33,11.023,{"$f":"AB63*AC63*AD63","v":353.43761395000001},24]
[null,null,null,"If yes, attach documentation from FDA."]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Case:",null,15,12.5,10.199999999999999,16.100000000000001,{"$f":"AB65*AC65*AD65","v":2052.75},96]
[null,null,"GTIN AND HIBCC PRODUCT INFORMATION"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Pallet:",null,22.4,47.24,39.369999999999997,47.24,{"$f":"AB67*AC67*AD67","v":87858.784912000003},3072]
[null,null,null,"Saleable Unit of Measure",null,null,"Saleable Quantity",null,null,"HIBCC",null,null,null,"GTIN-14",null,null,null,null,"Unit of Use GTIN-14"]
[null,null,null,"x","Item/Each",null,1,null,null,null,null,null,null,"00372241053221"]
[null," ",null,"x","Box/Carton/Bundle/Inner Pack",null,24,null,null,null,null,null,null,20372241053225,null,null,null,null,null,null,null,null,null,"COST INFORMATION",null,null,null,null,"WHOLESALER USE ONLY:"]
[null,null,null,"x","Case",null,96,null,null,null,null,null,null,40372241053229]
[null,null,null,"x","Pallet",null,3072,null,null,null,null,null,null,50372241053226,null,null,null,null,null,null,null,null,null,null,"Regular Cost Per Unit of Sale ($) ",null,null,null,"Vendor #:"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Invoice Cost (WAC) ($) ",null,null,"$       6.10 ","Whsl. Code #:  "]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Fineline Code: "]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"As of date:",null,"2024-06-03"]
[]
[]
[]
[null,null,"Attach copy of SAFETY DATA SHEET (SDS) or non hazard letter, PACKAGE INSERT, LABEL AND PHOTO OF PRODUCT PACKAGING and BARCODE."]
[null,null,"*Please provide any additional information on page 2.",null,null,null,null,null,null,null,null,null,null,null,"See new p. 3 for Designated Drop Ship Only.",null,null,null,null,null,null,null,null,null,null,"Signature:"]

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[]
[]
[null,null,"Standard Pharmaceutical Product and Medical Device Information (Rx Product Only)"]
[null,null,{"$f":"'Blank Template P1'!C4:E4","v":"Version 2021"},null,null,null,null,null,null,null,null,"For Designated Drop Ship Only Products, Please Use Page 3"]
[]
[null," MATERIAL HAZARD CLASSIFICATION and TRANSPORTATION"]
[]
[null,null," Is this product (check all that apply):"]
[null,null,null,"a. Cytotoxic?     ",null,null,null,null,null,null,null,null,null,"No",null,null,"SDS Hazard Classification"]
[null,null,null,"b. CA Prop. 65 Carcinogen or Reproductive Toxicant?"]
[null,null,null,null,"Is the product a CA Prop 65 carcinogen?",null,null,null,null,null,null,null,null,"No",null,null,null,null," Organic",null,null,null," Corrosive"]
[null,null,null,null,"Is the product a CA Prop 65 reproductive toxicant?",null,null,null,null,null,null,null,null,"No",null,null,null,null," Inorganic",null,null,null," Oxidizer"]
[null,null,null,null,"Does the product label bear a CA Prop 65 warning?",null,null,null,null,null,null,null,null,"No",null,null,null,null," Steroid/Androgen",null,null,null," Contact Hazard"]
[]
[null,null,null,"c. Contact Hazard?",null,null,null,null,null,null,null,null,null,"No",null,null,null,"Does the product have an Aerosol class? If yes, identify NFPA Storage Level:",null,null,null,null,"No"]
[null,null,null,"d. Does this product require special clean-up instructions?",null,null,null,null,null,null,null,null,null,"No",null," "]
[null,null,null," ",null,"(If yes, attach SDS with special instructions.)",null,null,null,null,null,null,null,null,null,null,null,"NFPA Storage Level:  "]
[null,null,null,"e. Does the product contain DEHP?",null,null,null,null,null,null,null,null,null,"No"]
[]
[null,null,"Is this product regulated for shipment by DOT?",null,null,null,null,null,null,null,null,null,null,"No",null,null,null,"Is the product a NIOSH hazardous drug?"]
[null,null,null,"(if yes, answer a-e below and provide SDS)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"If yes, indicate which:"]
[null,null,null,"a. UN/Identification Number"]
[null,null,null,"b. Proper Shipping Name"]
[null,null,null,"c. DOT Hazard Class",null,null,null,null,null,null,null,null,null,null,null,null,"Hazardous Waste Identification"]
[null,null,null,"d. Packing Group"]
[null,null,null,"e. Inhalation Hazard?",null,null,null,null,null,null,null,null,null,"No",null,null,null,"EPA Hazardous Waste Code:",null,null,null,null,null,null,null,null,"Waste Characteristics"]
[]
[null,null,"Is this product regulated for shipment by IATA?",null,null,null,null,null,null,null,null,null,null,"No"]
[null,null,null,"(if yes, answer a-e below and provide SDS)",null,null,null,null,null,null,null,null,null,null,null,"REMS or REGISTRY RESTRICTIONS  "]
[null,null,null,"a. UN/Identification Number"]
[null,null,null,"b. Proper Shipping Name",null,null,null,null,null,null,null,null,null,null,null,null,"Is there a REMS on this product? ",null,null,null,null,null,"No"]
[null,null,null,"c. DOT Hazard Class",null,null,null,null,null,null,null,null,null,null,null,null,null,"If Yes, is it managed with a pharmacy registry?"]
[null,null,null,"d. Packing Group",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Website URL:"]
[null,null,null,"e. Inhalation Hazard?",null,null,null,null,null,null,null,null,null,"No"]
[]
[null,null,"Is the product restricted for air shipment?  If so, indicate restriction:",null,null,null,null,null,null,null,null,null,null,"No",null,null,"Med Guide Required",null,null,null,null,null,"No"]
[null,null,null,null," Passenger",null,null,null,null,null,null,null,null,null,null,null,"Limited Distribution Requirement"]
[null,null,null,null," Cargo",null,null,null,null,null,null,null,null,null,null,null,"Comments / Details: (For example, iPledge program?)"]
[null,null,null,null," Passenger & Cargo"]
[]
[null,null,"Is this a reportable quantity?",null,null,null,null,null,null,null,null,null,null,null,null," ","REMS:"]
[null,null,null,"RQ Threshold:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"REMS Program Manager Name:",null,null,null,null,null,null,null,null,"Phone:"]
[null,null,"Is this a marine pollutant?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Supplier Manages REMS registry exclusively:"]
[null,null,"Is this product shipped utilizing an authorized DOT exception or Special Permit? ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"     Wholesale distributor support:"]
[null,null,null,"No",null,"  (if yes, identify method below)",null,null,null,null,null,null,null,null,null,null,null,null,"     Provider Name:",null,null,null,null,null,null,null,null,"DEA #:"]
[null,null,null,null," Limited Quantity",null,null,null,null,null,null,null,null,null,null,null,null,null,"     Site Enrollment Number assigned",null,null,null,null,null,null,null,null,"NCPDP#:"]
[null,null,null,null," Consumer Commodity, ORM-D",null,null,null,null,null,null,null,null,null,null,null,null,null,"     by Supplier:",null,null,null,null,null,null,null,null,"NPI #:"]
[null,null,null,null," Small Quantity (49 CFR 173.4)"]
[null,null,null,null," Special Permit; DOT-SP",null,null,null,null,null,null,null,null,null,null,null,null,null,"Comments "]
[null,null,null,null," Special Provision (listed in Column 7 of 49 CFR 172.101); "]
[null,null,null,null," SP#",null,null,null,null,null,null,null,null,null,null,null,"Registry:"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Registry Program Contact Name:",null,null,null,null,null,null,null,null,"Phone:"]
[null,"ADD'L STORAGE INFORMATION",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Comments "]
[]
[null,null,"Is the Product…       "]
[null,null,"  Controlled Substance?",null,null,null,null,null,"No",null,"  Controlled Substance Code",null,null,null,null,"RETURN INSTRUCTIONS"]
[null,null,"  Controlled by State(s)?",null,null,null,null,null,"No",null,"  Listed Chemical (List I or II)"]
[null,null,"  ARCOS Reportable?",null,null,null,null,null,"No",null,null,"If yes, indicate which:",null,null," ",null,"Contact tel. # if product received damaged:",null,null,null,null,null,"800-688-4697"]
[null,null,"  Schedule No.",null,null,null,null,null,null,null,null,"Is it a scheduled listed chemical product?:",null,"No",null,null,null,"Is product returnable for credit:",null,null,null,null,"Yes"]
[]
[null,"CLASS OF TRADE RESTRICTION: ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"URL/Link to returns policy:","ModavarCS@Eversana.com "]
[]
[null,null,"No restriction: Select YES if sold to retail pharmacy, hospitals, clinics and physician offices",null,null,null,null,null,null,null,null,null,null,"No"]
[]
[null,null,"Restricted to retail pharmacy only:",null,null,null,null,null,null,null,null,null,null,"No",null,null,"Special regulations or returns requirements for this product in certain states?"]
[]
[null,null,"Restricted to hospital, clinics, and physician offices only:",null,null,null,null,null,null,null,null,null,null,"No",null,null,null,null,null,null,null,null,"No"]
[null,null,"Restricted from US territories? (explain in comments)",null,null,null,null,null,null,null,null,null,null,"No",null,null,"If so, which states? Other requirements? Comments?"]
[]
[null,null,"Comments:"]
[]
[]
[]
[null,"MISCELLANEOUS NOTES and/or Image of Product Barcode:"]
[]
[]
[]
[]
[null,"Release DATE"]

{"sheet":"P3","index":2,"n_rows":60,"n_cols":21,"rows_kept":60,"cut":false,"hidden":false,"merged":[[11,8,11,9],[14,18,14,19],[13,18,13,19],[56,11,56,21],[51,13,54,20],[16,7,16,9],[15,7,15,9],[42,11,42,21],[36,18,36,20],[22,16,22,17],[35,12,38,14],[35,18,35,20],[30,12,31,17],[20,18,20,19],[48,6,48,9],[53,2,59,9],[2,2,2,20],[5,11,5,21],[5,1,5,10],[10,18,10,19],[8,16,8,17],[10,8,10,9],[9,8,9,9],[8,18,8,20],[3,2,3,4],[3,6,3,16],[38,4,40,9],[32,1,32,10],[37,18,37,20],[25,4,30,9],[51,1,51,10],[44,18,44,20],[48,12,48,19],[42,1,42,10],[44,5,44,6],[46,5,46,8],[45,5,45,8],[47,6,47,9],[49,6,49,9],[46,16,47,20],[18,11,18,21],[18,1,18,10],[12,8,12,9],[34,18,34,19],[30,18,31,19],[22,18,22,20],[32,18,32,20],[12,18,12,19],[13,5,13,8],[14,6,14,9]]}
[]
[]
[null,null,"Standard Pharmaceutical Product and Medical Device Information (Rx Product Only)"]
[null,null,{"$f":"'Blank Template P1'!C4:E4","v":"Version 2021"},null,null,null,"FOR DESIGNATED DROP SHIP PRODUCT ONLY - if not a designated drop ship, do not complete."]
[]
[null,"Order Method for Designated  Drop Ship Product",null,null,null,null,null,null,null,null,null,"Standard Order Receipt and Processing"]
[]
[null,null,"Purchase orders may be accepted by:",null,null,null,null,null,null,null,null,null,"Purchase order daily receipt cut off time by supplier"]
[null,null,"a.","EDI",null,null,"Yes",null,null,null,null,null,"Cut off time:",null,null,null,"2pm"]
[null,null,"b.","Autofax",null,null,null," Fax Number:"]
[null,null,"c.","Fax",null,null,null," Fax Number:",null,null,null,null,"Shipping lead time of PO:",null,null,null,null,"  Hours",null,null,"  Days"]
[null,null,"d.","Phone only",null,null,null," Phone No.:"]
[null,null,"e.","Supplier Web Site only",null,null,null," Site Address:",null,null,null,null,"Ships same day for next day receipt:"]
[null,null,"Minimum Order Quantity:",null,null,"6",null,null,null,null,null,null,"Ships for second day receipt:"]
[null,null,"Supplier's Customer Service Number:",null,null,null,"800-688-4697",null,null,null,null,null,"Ships regular ground for 3-10 days receipt:"]
[null,null,"Contracted 3PL company / contact #:",null,null,null,"Name:","Eversana Life Sciences"]
[null,null,null,null,null,null,"Phone:","800-688-4697"]
[]
[null,"Expedited Freight Charges or Other Designated Drop Ship Fees:",null,null,null,null,null,null,null,null,null,"Overnight and Priority Overnight PO Processing "]
[]
[null,null,"Expedited freight fees billed with each order:",null,null,null,null,null,null,null,null,null,"Overnight receipt available:"]
[]
[null,null,"Drop Ship service fee billed with each order:",null,null,null,null,null,null,null,null,null,"PO Receipt cut off time:"]
[]
[null,null,"Drop Ship miscellaneous fees billed:",null,null,null,null,null,null,null,null,null,null,null,"Days of week overnight is available:",null,null,null,null," Monday"]
[null,null,"Comments:",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," Tuesday"]
[" ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," Wednesday"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," Thursday"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," Friday"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"Priority Overnight receipt available:"]
[]
[null,"Class of Trade Restriction:",null,null,null,null,null,null,null,null,null,null,null,null,null,"PO Receipt Cut off time:"]
[]
[null,null,"No restriction: Select YES if sold to retail pharmacy, hospitals, clinics and physician offices",null,null,null,null,null,null,null,null,null,"Saturday Overnight receipt available:"]
[null,null,"Restricted to retail pharmacy only:",null,null,null,null,null,null,null,null,null,"Order receipt method:",null,null,"PO Receipt Cut off time:"]
[null,null,"Restricted to hospital, clinics, and physician offices only:",null,null,null,null,null,null,null,null,null,null,null,null,"Phone:",null," Phone #:"]
[null,null,"Restricted from US territories? (explain in comments)",null,null,null,null,null,null,null,null,null,null,null,null,"Fax:",null," Fax #:"]
[null,null,"Comments:",null,null,null,null,null,null,null,null,null,null,null,null,"EDI:"]
[null,null,null,null,null,null,null,null,null,null,null,null,"Overnight Fees apply:"]
[null,null,null,null,null,null,null,null,null,null,null,null,"Other fees apply:"]
[]
[null," Other Data Information Required to Process PO:",null,null,null,null,null,null,null,null,null,"Return Instructions"]
[]
[null,null,"Patient Procedure Date:",null,null,null,null,null,null,null,null,null,"Contact # if product is received damaged:",null,null,null,null,null,"800-688-4697"]
[null,null,"Physician Name:",null,null,null,null,null,null,null,null,null,"Is product returnable for credit:",null,null,null,null,null,null,null,"Yes"]
[null,null,"Physician/Clinic Phone #",null,null,null,null,null,null,null,null,null,"URL/Link to returns policy:",null,null,null,"www.modavar.com "]
[null,null,"Physician State License #"]
[null,null,"Physician/Clinic DEA #:",null,null,null,null,null,null,null,null,null,"Special regulations or returns requirements for this product in certain states?"]
[null,null,"Physician/Clinic Specialty:",null,null,null,null,null,null,null,null,null,null,"If so, which states? Other requirements? Comments?"]
[]
[null,"Miscellaneous Notes:"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"ADDITIONAL INFORMATION"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"Is product order for scheduled patient procedure?"]
[null,null,null,null,null,null,null,null,null,null,null,null,"Is product order for restocking purposes?"]

{"sheet":"Data Validation","index":3,"n_rows":14,"n_cols":22,"rows_kept":14,"cut":false,"hidden":true,"merged":[]}
[]
[]
[null,"Introduction Type","Application","Yes/No","Yes/No*","Product Type","Product Exemption","Item Type","Aerosol Class","Units/Dollars","Time Zone","Page Creation Selection","Page Removal Selection","Form Selection","Temperature Ranges","NIOSH Hazardous Drug","Listed Chemical","Orphan Drug Status","FDA Approval Status","Schedule No.","Waste Characteristics","Medical Device Class"]
[null,"New Item","NDA","Yes","*Yes","Direct-Ship Only","Blood, blood components intended for transfusion","Unit Dose","Level 1","Units","Eastern","All Pages","All Pages","Blank Template","Frozen – less than -25 C (< -13° F)","Group 1 items (antineoplastic)","Ephedrine","Designated","Approved for Orphan Indication",2,"D001","Class I with exemptions"]
[null,"Promotion/Deal","ANDA","No","No","Drop-Ship Only","Radioactive drugs, radioactive biologics","Unit of Use","Level 2","Dollars","Central","Only Pages 1 and 2","Only Page 3",null,"Freezer – between -25 and -10 C (-13° – 14° F)","Group 2 items (non-antineoplastic that meets a hazard criterion)","Pseudoephedrine","Approved",null,"2N","D002","Class I without exemptions"]
[null,"Open Stock","BLA",null,null,"Direct And Drop-Ship","Imaging drugs","Neither","Level 3",null,"Pacific",null,null,null,"Cold – between 2 and 8 C (36° – 46° F)","Group 3 items (primarily adverse reproductive effects)","Phenylpropanolamine",null,null,3,"D003","Class II with exemptions"]
[null,"Post Launch Change","Med Device",null,null,null,"Certain intravenous products ",null,null,null,null,null,null,null,"Cool – between 8 and 15 C (46° – 59° F)",null,"Iodine (≥2.2%)",null,null,"3N","D004","Class II without exemptions"]
[null,null,null,null,null,null,"Medical gas",null,null,null,null,null,null,null,"Controlled Room – between 20 and 25 C (68° – 77° F)",null,null,null,null,4,null,"Class III PMA"]
[null,null,null,null,null,null,"Compounded drugs",null,null,null,null,null,null,null,"Avoid Excessive Heat – above 40 C (>104° F)",null,null,null,null,5,null,"Class III Pre-PMA"]
[null,null,null,null,null,null,"Certain medical convenience kits, combo products"]
[null,null,null,null,null,null,"Sterile water, products intended for irrigation"]
[null,null,null,null,null,null,"Homeopathic drugs"]
[null,null,null,null,null,null,"Medical device"]
[null,null,null,null,null,null,"Other exemption:  (Write in)"]