| NAME |
HYALURONATE NA (HEALON D OVD) INJ,OPH,SYRINGE,KIT |
| VA GENERIC NAME |
HYALURONATE SODIUM |
| DOSAGE FORM |
INJ |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2023-01-17 00:00:00 |
| NATIONAL FORMULARY NAME |
HYALURONATE SODIUM INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
HYALURONATE NA (HEALON D OVD) OPH KIT |
| VA PRODUCT IDENTIFIER |
H0553 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4028552 |
| EFFECTIVE DATE/TIME |
-
- 2009-04-08 00:00:00
- STATUS: ACTIVE
-
- 2023-01-17 00:00:00
- STATUS: INACTIVE
|
