| NAME |
MOMETASONE 25MCG/OLOPATADINE 665MCG/SPRAY SUSP,NASAL,29GM |
| VA GENERIC NAME |
MOMETASONE/OLOPATADINE |
| DOSAGE FORM |
SUSP,NASAL |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
MOMETASONE/OLOPATADINE SUSP,NASAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2023-03-29 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
RYALTRIS 665MCG/25MCG 240D NASAL SPRAY |
| VA PRODUCT IDENTIFIER |
R0457 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042132 |
| EFFECTIVE DATE/TIME |
-
- 2023-03-29 00:00:00
- STATUS: ACTIVE
|
