ERYTHROMYCIN BASE 250MG CAP,EC (22738)    VA PRODUCT (50.68)

Name Value
NAME ERYTHROMYCIN BASE 250MG CAP,EC
VA GENERIC NAME ERYTHROMYCIN
DOSAGE FORM CAP,EC
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR NO
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 250
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
NATIONAL FORMULARY NAME ERYTHROMYCIN CAP,EC
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 ERYTHROMYCIN BASE 250MG EC CAP
VA PRODUCT IDENTIFIER E0571
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4031087
EFFECTIVE DATE/TIME
  • 2011-11-04 00:00:00
    STATUS:   ACTIVE