POLYVINYL ALCOHOL 1% (PF) SOLN,OPH (8866)    VA PRODUCT (50.68)

Name Value
NAME POLYVINYL ALCOHOL 1% (PF) SOLN,OPH
VA GENERIC NAME POLYVINYL ALCOHOL
DOSAGE FORM SOLN,OPH
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 1
INACTIVATION DATE 2012-03-23 00:00:00
UNITS %
DSS NUMBER 4
NATIONAL FORMULARY NAME POLYVINYL ALCOHOL 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 ARTIFICIAL TEARS POLYVINYL ALCOHOL (PF)
VA PRODUCT IDENTIFIER A0567
TRANSMIT TO CMOP YES
VA DISPENSE UNIT 0.6ML EACH
MASTER ENTRY FOR VUID YES
VUID 4009319
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-27 00:00:00
    STATUS:   INACTIVE
  • 2007-10-10 00:00:00
    STATUS:   ACTIVE
  • 2012-03-23 00:00:00
    STATUS:   INACTIVE