DORZOLAMIDE HCL 22.3MG/TIMOLOL MALEATE 6.8MG/ML (PF) SOLN,OPH (23004) VA PRODUCT (50.68)

Name	Value
NAME	DORZOLAMIDE HCL 22.3MG/TIMOLOL MALEATE 6.8MG/ML (PF) SOLN,OPH
VA GENERIC NAME	DORZOLAMIDE/TIMOLOL
DOSAGE FORM	SOLN,OPH
ACTIVE INGREDIENTS	DORZOLAMIDE HYDROCHLORIDE STRENGTH: 22.3 UNITS: MG/ML TIMOLOL MALEATE STRENGTH: 6.8 UNITS: MG/ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	DORZOLAMIDE/TIMOLOL 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	DORZOLAMIDE 22.3/TIMOLOL6.8MG/ML PF OPH
VA PRODUCT IDENTIFIER	D0938
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	0.2ML EACH
MASTER ENTRY FOR VUID	YES
VUID	4031388
EFFECTIVE DATE/TIME	2012-04-06 00:00:00 STATUS: ACTIVE