AMOXICILLIN TRIHYDRATE 250MG/CLAVULANATE K 125MG/5ML SUSP (4123)    VA PRODUCT (50.68)

Name Value
NAME AMOXICILLIN TRIHYDRATE 250MG/CLAVULANATE K 125MG/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 2002-09-26 00:00:00
DSS NUMBER 8
NATIONAL FORMULARY NAME AMOXICILLIN/CLAVULANATE PWDR,RENST-ORAL
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 AMOXICILLIN 250/CLAV K 125MG/5ML SUSP
VA PRODUCT IDENTIFIER A0277
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4004675
EFFECTIVE DATE/TIME
  • 2002-09-26 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE