| NAME |
DEXTRAN 0.1%/HYPROMELLOSE 0.8% (OCUCOAT) SOLN,OPH,1ML |
| VA GENERIC NAME |
DEXTRAN 70/HYPROMELLOSE |
| DOSAGE FORM |
SOLN,OPH |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| INACTIVATION DATE |
2022-06-15 00:00:00 |
| NATIONAL FORMULARY NAME |
DEXTRAN 70/HYPROMELLOSE SOLN,OPH |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
OCUCOAT (PF) OPH SOLN 1ML |
| VA PRODUCT IDENTIFIER |
D0742 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
SYR |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4025921 |
| EFFECTIVE DATE/TIME |
-
- 2007-03-01 00:00:00
- STATUS: ACTIVE
-
- 2022-06-15 00:00:00
- STATUS: INACTIVE
|
