DOXYCYCLINE HYCLATE 20MG TAB (15165)    VA PRODUCT (50.68)

Name Value
NAME DOXYCYCLINE HYCLATE 20MG TAB
VA GENERIC NAME DOXYCYCLINE
DOSAGE FORM TAB
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 20
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
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 20MG TAB
VA PRODUCT IDENTIFIER D0539
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4015529
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2020-01-09 00:00:00
    STATUS:   ACTIVE