EYE-STREAM SOLN,OPH IRRG (9233) VA PRODUCT (50.68)

Name	Value
NAME	EYE-STREAM SOLN,OPH IRRG
VA GENERIC NAME	BENZALKONIUM/CALCIUM CHLORIDE/HYDROCHLORIC ACID/MAGNESIUM CHLORI
DOSAGE FORM	SOLN,OPH IRRG
ACTIVE INGREDIENTS	SODIUM ACETATE STRENGTH: 0.39 UNITS: % SODIUM CHLORIDE STRENGTH: 0.49 UNITS: % POTASSIUM CHLORIDE STRENGTH: 0.075 UNITS: % SODIUM HYDROXIDE SODIUM CITRATE STRENGTH: 0.17 UNITS: % CALCIUM CHLORIDE STRENGTH: 0.048 UNITS: % MAGNESIUM CHLORIDE STRENGTH: 0.03 UNITS: % HYDROCHLORIC ACID BENZALKONIUM CHLORIDE STRENGTH: 0.013 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2020-03-16 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	BENZALKONIUM/CALCIUM CHLORIDE/HYDROCHLORIC ACID/MAGNESIUM CHLORI SOLN,OPH IRRG
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	EYE-STREAM SOLN,OPH IRRG
VA PRODUCT IDENTIFIER	E0337
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4009663
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2020-03-16 00:00:00 STATUS: INACTIVE