| NAME |
AMOXICILLIN TRIHYDRATE 400MG/CLAVULANATE K 57MG TAB,CHEWABLE |
| VA GENERIC NAME |
AMOXICILLIN/CLAVULANATE |
| DOSAGE FORM |
TAB,CHEWABLE |
| FORMULARY DESIGNATOR |
R |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| INACTIVATION DATE |
2011-02-03 00:00:00 |
| NATIONAL FORMULARY NAME |
AMOXICILLIN/CLAVULANATE TAB,CHEWABLE |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| 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 400MG/CLAVUL 57MG CHEW TAB |
| VA PRODUCT IDENTIFIER |
A1049 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
TAB |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4014654 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2011-02-03 00:00:00
- STATUS: INACTIVE
|
