DOXYCYCLINE HYCLATE 50MG CAP/TAB (25320)    VA PRODUCT (50.68)

Name Value
NAME DOXYCYCLINE HYCLATE 50MG CAP/TAB
VA GENERIC NAME DOXYCYCLINE
DOSAGE FORM CAP/TAB
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 50
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2020-01-21 00:00:00
UNITS MG
NATIONAL FORMULARY NAME DOXYCYCLINE CAP/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 50MG CAP/TAB
VA PRODUCT IDENTIFIER D1079
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP/TAB
MASTER ENTRY FOR VUID YES
VUID 4034020
EFFECTIVE DATE/TIME
  • 2014-12-31 00:00:00
    STATUS:   ACTIVE
  • 2020-01-21 00:00:00
    STATUS:   INACTIVE