DOXYCYCLINE HYCLATE 50MG TAB (1362)    VA PRODUCT (50.68)

Name Value
NAME DOXYCYCLINE HYCLATE 50MG TAB
VA GENERIC NAME DOXYCYCLINE
DOSAGE FORM TAB
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 50
UNITS MG
DSS NUMBER 6
NATIONAL FORMULARY NAME DOXYCYCLINE TAB
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 50MG TAB
VA PRODUCT IDENTIFIER D0259
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4001963
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2012-06-06 00:00:00
    STATUS:   INACTIVE
  • 2020-01-09 00:00:00
    STATUS:   ACTIVE