ERYTHROMYCIN ESTOLATE 250MG TAB (992)    VA PRODUCT (50.68)

Name Value
NAME ERYTHROMYCIN ESTOLATE 250MG TAB
VA GENERIC NAME ERYTHROMYCIN
DOSAGE FORM TAB
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 250
INACTIVATION DATE 2007-09-18 00:00:00
UNITS MG
DSS NUMBER 46
NATIONAL FORMULARY NAME ERYTHROMYCIN TAB
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 ERYTHROMYCIN ESTOLATE 250MG TAB
VA PRODUCT IDENTIFIER E0135
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4001596
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-18 00:00:00
    STATUS:   INACTIVE