RIBOLFAVIN (PHOTREXA) CROSS-LINKING KIT (31164)    VA PRODUCT (50.68)

Name Value
NAME RIBOLFAVIN (PHOTREXA) CROSS-LINKING KIT
VA GENERIC NAME RIBOFLAVIN
DOSAGE FORM SOLN,OPH
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2021-08-03 00:00:00
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 RIBOLFAVIN (PHOTREXA) CROSS-LINKING KIT
VA PRODUCT IDENTIFIER R0429
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4040521
EFFECTIVE DATE/TIME
  • 2021-05-28 00:00:00
    STATUS:   ACTIVE
  • 2021-05-28 00:00:00
    STATUS:   ACTIVE
  • 2021-08-03 00:00:00
    STATUS:   INACTIVE
  • 2021-05-28 00:00:00
    STATUS:   ACTIVE
  • 2021-08-03 00:00:00
    STATUS:   INACTIVE