| NAME |
AMOXICILLIN TRIHYDRATE 250MG/CLAVULANATE K 62.5MG/5ML SUSP |
| VA GENERIC NAME |
AMOXICILLIN/CLAVULANATE |
| DOSAGE FORM |
PWDR,RENST-ORAL |
| FORMULARY DESIGNATOR |
R |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2011-09-13 00:00:00 |
| DSS NUMBER |
6 |
| NATIONAL FORMULARY NAME |
AMOXICILLIN/CLAVULANATE PWDR,RENST-ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
AMOXICILLIN 250/CLAV K 62.5MG/5ML SUSP |
| VA PRODUCT IDENTIFIER |
A0264 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4004673 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2011-09-13 00:00:00
- STATUS: INACTIVE
|
