CARBOXYMETHYLCELLULOSE 0.5/GLYCERIN 1/POLYSORB 0.5%SOL,OPH,0.4ML (28644) VA PRODUCT (50.68)

Name	Value
NAME	CARBOXYMETHYLCELLULOSE 0.5/GLYCERIN 1/POLYSORB 0.5%SOL,OPH,0.4ML
VA GENERIC NAME	CARBOXYMETHYLCELLULOSE/GLYCERIN/POLYSORBATE
DOSAGE FORM	SOLN,OPH
ACTIVE INGREDIENTS	GLYCERIN STRENGTH: 1 UNITS: % POLYSORBATE 80 STRENGTH: 0.5 UNITS: % CARBOXYMETHYLCELLULOSE SODIUM STRENGTH: 0.5 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	CARBOXYMETHYLCELLULOSE/GLYCERIN/POLYSORBATE SOLN,OPH
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2018-07-18 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	REFRESH OPTIVE ADVANCED OPH SOLN 0.4ML
VA PRODUCT IDENTIFIER	R0415
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4037677
EFFECTIVE DATE/TIME	2018-07-18 00:00:00 STATUS: ACTIVE