OXYMETAZOLINE HCL 0.1MG/TETRACAINE HCL 6MG/0.2ML SOLN,SPRAY,NASL (27672) VA PRODUCT (50.68)

Name	Value
NAME	OXYMETAZOLINE HCL 0.1MG/TETRACAINE HCL 6MG/0.2ML SOLN,SPRAY,NASL
VA GENERIC NAME	OXYMETAZOLINE/TETRACAINE
DOSAGE FORM	SOLN,SPRAY,NASAL
ACTIVE INGREDIENTS	OXYMETAZOLINE HYDROCHLORIDE STRENGTH: 0.1 UNITS: MG/0.2ML TETRACAINE HYDROCHLORIDE STRENGTH: 6 UNITS: MG/0.2ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	OXYMETAZOLINE/TETRACAINE SOLN,SPRAY,NASAL
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	No Possible Dosages
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-06-01 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	KOVANAZE SOLN NASAL SPRAY
VA PRODUCT IDENTIFIER	K0067
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4036610
EFFECTIVE DATE/TIME	2017-04-27 00:00:00 STATUS: ACTIVE