CONTACT LENS REWETTING (BOSTON ADVANCE) SOLN (12235)    VA PRODUCT (50.68)

Name Value
NAME CONTACT LENS REWETTING (BOSTON ADVANCE) SOLN
VA GENERIC NAME BOSTON
DOSAGE FORM SOLN,CONTACT LENS
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2016-05-16 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME BOSTON SOLN
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 CONTACT LENS REWETTNG BOSTON ADVANCE SLN
VA PRODUCT IDENTIFIER C0601
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4012601
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE