POLYVINYL ALCOHOL 0.5%/POVIDONE 0.6% SOLN,OPH (22970) VA PRODUCT (50.68)

Name	Value
NAME	POLYVINYL ALCOHOL 0.5%/POVIDONE 0.6% SOLN,OPH
VA GENERIC NAME	POLYVINYL ALCOHOL/POVIDONE
DOSAGE FORM	SOLN,OPH
ACTIVE INGREDIENTS	POLYVINYL ALCOHOL STRENGTH: 0.5 UNITS: % POVIDONE STRENGTH: 0.6 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	POLYVINYL ALCOHOL/POVIDONE SOLN,OPH
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	ARTIFICIAL TEARS PVA 0.5%/POVIDONE
VA PRODUCT IDENTIFIER	P1001
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4031354
EFFECTIVE DATE/TIME	2012-04-06 00:00:00 STATUS: ACTIVE