| NAME |
CONTACT LENS CONDITIONING (BOSTON ADVANCE) SOLN |
| VA GENERIC NAME |
BOSTON |
| DOSAGE FORM |
SOLN,CONTACT LENS |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR |
PA-F |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
BOSTON SOLN,CONTACT LENS |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2018-11-30 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
CONTACT LENS CONDITION BOSTON ADV SOLN |
| VA PRODUCT IDENTIFIER |
C1876 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4038025 |
| EFFECTIVE DATE/TIME |
-
- 2018-12-03 00:00:00
- STATUS: ACTIVE
|
