EDTA/HYDROXYPROPYL ME CELLULOSE/POLYQYARTERNIUM-1 SOLN,OPH (10169) VA PRODUCT (50.68)

Name	Value
NAME	EDTA/HYDROXYPROPYL ME CELLULOSE/POLYQYARTERNIUM-1 SOLN,OPH
VA GENERIC NAME	EDTA/HYDROXYPROPYL/POLYQUARTERNIUM-1/POTASSIUM/SODIUM
DOSAGE FORM	SOLN,OPH
ACTIVE INGREDIENTS	HYDROXYPROPYL METHYLCELLULOSE POLYQUATERNIUM-1 SODIUM CHLORIDE EDTA STRENGTH: 0.1 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2000-04-18 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	EDTA/HYDROXYPROPYL/POLYQUARTERNIUM-1/POTASSIUM/SODIUM SOLN,OPH
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	ARTIFICIAL TEARS METHYLCELLULOSE
VA PRODUCT IDENTIFIER	D0176
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4010546
EFFECTIVE DATE/TIME	2000-04-18 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE