AZITHROMYCIN 1GM/PKT PWDR,ORAL (9752)    VA PRODUCT (50.68)

Name Value
NAME AZITHROMYCIN 1GM/PKT PWDR,ORAL
VA GENERIC NAME AZITHROMYCIN
DOSAGE FORM PWDR,RENST-ORAL
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 1
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS GM/PKT
DSS NUMBER 5
NATIONAL FORMULARY NAME AZITHROMYCIN 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 AZITHROMYCIN 1GM/PKT ORAL PWDR
VA PRODUCT IDENTIFIER A0719
TRANSMIT TO CMOP NO
VA DISPENSE UNIT PKT
MASTER ENTRY FOR VUID YES
VUID 4010161
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE