AMOXICILLIN 200MG/CLAVULANATE K 28.5MG TAB,CHEWABLE (4128)    VA PRODUCT (50.68)

Name Value
NAME AMOXICILLIN 200MG/CLAVULANATE K 28.5MG TAB,CHEWABLE
VA GENERIC NAME AMOXICILLIN/CLAVULANATE
DOSAGE FORM TAB,CHEWABLE
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
DSS NUMBER 13
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 200/CLAV K 28.5MG CHEW TAB
VA PRODUCT IDENTIFIER A0710
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4004680
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE