GLYCERIN 0.5%/NAPHAZOLINE HCL 0.03% SOLN,OPH (26747)    VA PRODUCT (50.68)

Name Value
NAME GLYCERIN 0.5%/NAPHAZOLINE HCL 0.03% SOLN,OPH
VA GENERIC NAME GLYCERIN/NAPHAZOLINE
DOSAGE FORM SOLN,OPH
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME GLYCERIN/NAPHAZOLINE 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 GLYCERIN 0.5%/NAPHAZOLINE 0.03% OPH SOL
VA PRODUCT IDENTIFIER G0429
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4035585
EFFECTIVE DATE/TIME
  • 2016-03-31 00:00:00
    STATUS:   ACTIVE