CONTACT LENS CONDITIONING (BOSTON) SOLN (12237)    VA PRODUCT (50.68)

Name Value
NAME CONTACT LENS CONDITIONING (BOSTON) 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
DSS NUMBER 3
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 CONDITIONING BOSTON SOLN
VA PRODUCT IDENTIFIER C0605
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4012603
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE