DOXYCYCLINE HYCLATE 100MG CAP,UD (15702)    VA PRODUCT (50.68)

Name Value
NAME DOXYCYCLINE HYCLATE 100MG CAP,UD
VA GENERIC NAME DOXYCYCLINE
DOSAGE FORM CAP,ORAL
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 100
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
NATIONAL FORMULARY NAME DOXYCYCLINE CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Inpatient
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 100MG CAP UD
VA PRODUCT IDENTIFIER D0586
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4016065
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE