| NAME |
EYELID CLEANSER,EYE SCRUB LIQUID,TOP |
| VA GENERIC NAME |
EYELID CLEANSER |
| DOSAGE FORM |
LIQUID,TOP |
| NATIONAL FORMULARY NAME |
EYELID CLEANSER LIQUID,TOP |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-09-01 00:00:00
- COPAY END DATE: 2019-03-20 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2019-03-21 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
EYELID CLEANSER,EYE SCRUB TOP LIQUID |
| VA PRODUCT IDENTIFIER |
E0713 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4036810 |
| EFFECTIVE DATE/TIME |
-
- 2017-07-14 00:00:00
- STATUS: ACTIVE
|
