CYCLOSPORINE 0.09% (PF) SOLN,OPH,0.25ML (28954)    VA PRODUCT (50.68)

Name Value
NAME CYCLOSPORINE 0.09% (PF) SOLN,OPH,0.25ML
VA GENERIC NAME CYCLOSPORINE
DOSAGE FORM SOLN,OPH
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR TEXT
 
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 0.09
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS %
NATIONAL FORMULARY NAME CYCLOSPORINE SOLN,OPH
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2018-12-13 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME CYCLOSPORINE 0.09% (PF) OPH SOLN 0.25ML
VA PRODUCT IDENTIFIER C1880
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4038054
EFFECTIVE DATE/TIME
  • 2018-12-13 00:00:00
    STATUS:   ACTIVE