| NAME |
KETOROLAC 0.3%/PHENYLEPHRINE 1% CONC OPH IRR,4ML |
| VA GENERIC NAME |
KETOROLAC/PHENYLEPHRINE |
| DOSAGE FORM |
OPH IRR |
| FORMULARY DESIGNATOR |
PA-F |
| FORMULARY DESIGNATOR TEXT |
Restricted to Ophthalmology with use limited to high risk patients
|
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
KETOROLAC/PHENYLEPHRINE OPH IRR |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| 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 |
KETOROLAC 0.3/P-EPHR 1% CONC OPH IRR 4ML |
| VA PRODUCT IDENTIFIER |
K0061 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4034357 |
| EFFECTIVE DATE/TIME |
-
- 2015-04-14 00:00:00
- STATUS: ACTIVE
|
