| NAME |
DEXAMETHASONE 0.4MG IMPLANT,OPH |
| VA GENERIC NAME |
DEXAMETHASONE |
| DOSAGE FORM |
IMPLANT |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR TEXT |
Restricted to Ophth patients/ inadequate response, contraindication, or ADE to VEGF-inhibitors (DME,RVO) or to first-line treatments for posterior uveitis AND inadequate response or ADE to intravitreal triamcinolone or a trial isn't appropriate.
|
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
NO |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
0.4 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
DEXAMETHASONE IMPLANT |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2019-04-04 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DEXAMETHASONE 0.4MG OPH IMPLANT |
| VA PRODUCT IDENTIFIER |
D1206 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4038289 |
| EFFECTIVE DATE/TIME |
-
- 2019-04-04 00:00:00
- STATUS: ACTIVE
|
