RIBOFLAVIN (PHOTREXA) CROSS-LINKING KIT (31343) VA PRODUCT (50.68)

Name	Value
NAME	RIBOFLAVIN (PHOTREXA) CROSS-LINKING KIT
VA GENERIC NAME	RIBOFLAVIN
DOSAGE FORM	SOLN,OPH
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	RIBOFLAVIN PHOSPHATE STRENGTH: 0.146 UNITS: % DEXTRAN STRENGTH: 20 UNITS: %
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: 2021-08-03 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	RIBOFLAVIN (PHOTREXA) CROSS-LINKING KIT
VA PRODUCT IDENTIFIER	R0433
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	KIT
MASTER ENTRY FOR VUID	YES
VUID	4040721
EFFECTIVE DATE/TIME	2021-08-03 00:00:00 STATUS: ACTIVE 2021-08-03 00:00:00 STATUS: ACTIVE