RIBOFLAVIN 5-PHOSPHATE 0.146%/DEXTRAN 20% SOLN,OPH,SYR (31163)    VA PRODUCT (50.68)

Name Value
NAME RIBOFLAVIN 5-PHOSPHATE 0.146%/DEXTRAN 20% SOLN,OPH,SYR
VA GENERIC NAME RIBOFLAVIN
DOSAGE FORM SOLN,OPH
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME RIBOFLAVIN SOLN,OPH
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2021-05-28 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME RIBOFLAVIN 0.146/DEXTRAN20% SOLN OPH SYR
VA PRODUCT IDENTIFIER R0430
TRANSMIT TO CMOP NO
VA DISPENSE UNIT SYR
MASTER ENTRY FOR VUID YES
VUID 4040520
EFFECTIVE DATE/TIME
  • 2021-05-28 00:00:00
    STATUS:   ACTIVE
  • 2021-05-28 00:00:00
    STATUS:   ACTIVE
  • 2021-05-28 00:00:00
    STATUS:   ACTIVE