BORIC ACID 1.2%/KCL 0.38%/NA CARBONATE 0.014% SOLN IRRG,OPH (8473) VA PRODUCT (50.68)

Name	Value
NAME	BORIC ACID 1.2%/KCL 0.38%/NA CARBONATE 0.014% SOLN IRRG,OPH
VA GENERIC NAME	SODIUM BIPHOSPHATE/SODIUM CHLORIDE/SODIUM PHOSPHATE
DOSAGE FORM	SOLN,OPH
ACTIVE INGREDIENTS	SODIUM CARBONATE STRENGTH: 0.014 UNITS: % SODIUM CHLORIDE STRENGTH: 4.9 UNITS: MG/ML SODIUM BIPHOSPHATE STRENGTH: 4.0 UNITS: MG/ML BORIC ACID STRENGTH: 1.2 UNITS: % BENZALKONIUM CHLORIDE STRENGTH: 0.05 UNITS: MG/ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
INACTIVATION DATE	2015-05-22 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	SODIUM BIPHOSPHATE/SODIUM CHLORIDE/SODIUM PHOSPHATE SOLN,OPH
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	OPHTHALMIC IRRG SOLN
VA PRODUCT IDENTIFIER	B0207
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	NO
VUID	4008936
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2005-12-08 00:00:00 STATUS: ACTIVE 2004-11-18 00:00:00 STATUS: INACTIVE