OXYMORPHONE HCL 15MG TAB,SA,UD (23945)    VA PRODUCT (50.68)

Name Value
NAME OXYMORPHONE HCL 15MG TAB,SA,UD
VA GENERIC NAME OXYMORPHONE
DOSAGE FORM TAB,SA
FDA MED GUIDE Oxymorphone_SA_(Generic)_(2021).pdf
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Schedule II
STRENGTH 15
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2016-01-25 00:00:00
UNITS MG
NATIONAL FORMULARY NAME OXYMORPHONE TAB,SA
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME OXYMORPHONE HCL 15MG SA TAB UD
VA PRODUCT IDENTIFIER O0341
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4032458
EFFECTIVE DATE/TIME
  • 2013-06-17 00:00:00
    STATUS:   ACTIVE