BRIMONIDINE TARTRATE 0.2%/TIMOLOL MALEATE 0.5% SOLN,OPH (19364) VA PRODUCT (50.68)

Name	Value
NAME	BRIMONIDINE TARTRATE 0.2%/TIMOLOL MALEATE 0.5% SOLN,OPH
VA GENERIC NAME	BRIMONIDINE/TIMOLOL
DOSAGE FORM	SOLN,OPH
ACTIVE INGREDIENTS	BRIMONIDINE TARTRATE STRENGTH: 0.2 UNITS: % TIMOLOL MALEATE STRENGTH: 0.5 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	BRIMONIDINE/TIMOLOL SOLN,OPH
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00 COPAY END DATE: 2022-01-26 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2022-01-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	BRIMONIDINE 0.2%/TIMOLOL 0.5% OPH SOLN
VA PRODUCT IDENTIFIER	B0603
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4027224
EFFECTIVE DATE/TIME	2008-03-07 00:00:00 STATUS: ACTIVE