| NAME |
CIPROFLOXACIN HCL 0.3%/FLUOCINOLONE 0.025% (PF) SOLN,OTIC,0.25ML |
| VA GENERIC NAME |
CIPROFLOXACIN/FLUOCINOLONE |
| DOSAGE FORM |
SOLN,OTIC |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
CIPROFLOXACIN/FLUOCINOLONE SOLN,OTIC |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
- COPAY END DATE: 2019-11-06 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2019-11-07 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
CIPROFLOX 0.3/FLUOCIN 0.025% OTIC 0.25ML |
| VA PRODUCT IDENTIFIER |
C1785 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035980 |
| EFFECTIVE DATE/TIME |
-
- 2016-08-12 00:00:00
- STATUS: ACTIVE
|
