DOXYCYCLINE HYCLATE 20MG CAP (12988)    VA PRODUCT (50.68)

Name Value
NAME DOXYCYCLINE HYCLATE 20MG CAP
VA GENERIC NAME DOXYCYCLINE
DOSAGE FORM CAP,ORAL
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 20
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2020-03-16 00:00:00
UNITS MG
NATIONAL FORMULARY NAME DOXYCYCLINE 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
VA PRINT NAME DOXYCYCLINE HYCLATE 20MG CAP
VA PRODUCT IDENTIFIER D0425
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4013353
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-19 00:00:00
    STATUS:   INACTIVE
  • 2020-01-09 00:00:00
    STATUS:   ACTIVE
  • 2020-03-16 00:00:00
    STATUS:   INACTIVE