AMOXICILLIN TRIHYDRATE 250MG/5ML SUSP (1040)    VA PRODUCT (50.68)

Name Value
NAME AMOXICILLIN TRIHYDRATE 250MG/5ML SUSP
VA GENERIC NAME AMOXICILLIN
DOSAGE FORM PWDR,RENST-ORAL
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 250
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG/5ML
DSS NUMBER 6
NATIONAL FORMULARY NAME AMOXICILLIN PWDR,RENST-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
VA PRINT NAME AMOXICILLIN 250MG/5ML SUSP
VA PRODUCT IDENTIFIER A0275
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4001644
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE