AMOXICILLIN 250MG/CLAVULANATE K 62.5MG TAB,CHEWABLE (4124)    VA PRODUCT (50.68)

Name Value
NAME AMOXICILLIN 250MG/CLAVULANATE K 62.5MG TAB,CHEWABLE
VA GENERIC NAME AMOXICILLIN/CLAVULANATE
DOSAGE FORM TAB,CHEWABLE
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2011-05-04 00:00:00
DSS NUMBER 9
NATIONAL FORMULARY NAME AMOXICILLIN/CLAVULANATE TAB,CHEWABLE
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 62.5MG CHEW TAB
VA PRODUCT IDENTIFIER A0263
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4004676
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2011-05-04 00:00:00
    STATUS:   INACTIVE