AMOXICILLIN/OMEPRAZOLE/RIFABUTIN 250/10/12.5MG CAP,EC (29837) VA PRODUCT (50.68)

Name	Value
NAME	AMOXICILLIN/OMEPRAZOLE/RIFABUTIN 250/10/12.5MG CAP,EC
VA GENERIC NAME	AMOXICILLIN/OMEPRAZOLE/RIFABUTIN
DOSAGE FORM	CAP,EC
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	AMOXICILLIN STRENGTH: 250 UNITS: MG OMEPRAZOLE STRENGTH: 10 UNITS: MG RIFABUTIN STRENGTH: 12.5 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	AMOXICILLIN/OMEPRAZOLE/RIFABUTIN CAP,EC
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2020-01-02 00:00:00
PGX ELIGIBLE	YES
PGX SUPPRESSED	NO
VA PRINT NAME	AMOX/OMEPRAZ/RIFAB 250/10/12.5MG CAP,EC
VA PRODUCT IDENTIFIER	A2116
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4039047
EFFECTIVE DATE/TIME	2020-01-02 00:00:00 STATUS: ACTIVE