CONTACT LENS RINSE/NEUTRALIZER (OXYSEPT 2) SOLN,15ML (12239) VA PRODUCT (50.68)

Name	Value
NAME	CONTACT LENS RINSE/NEUTRALIZER (OXYSEPT 2) SOLN,15ML
VA GENERIC NAME	OXYSEPT
DOSAGE FORM	SOLN,CONTACT LENS
FORMULARY DESIGNATOR	PA-F
FORMULARY DESIGNATOR TEXT	Restricted to veterans who receive their contact lens from the VA
ACTIVE INGREDIENTS	SODIUM PHOSPHATE,MONOBASIC SODIUM PHOSPHATE,DIBASIC SODIUM CHLORIDE CATALASE EDTA
NATIONAL FORMULARY INDICATOR	YES
CS FEDERAL SCHEDULE	Unscheduled
DSS NUMBER	2
NATIONAL FORMULARY NAME	OXYSEPT 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 RINSE OXYSEPT-2 SOLN 15ML
VA PRODUCT IDENTIFIER	C0604
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4012605
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE