DEXTRAN 70 & HYDROXYPROPYL METHYLCELLULOSE & POLYQUAD Ontario LU Codes and Criteria

Drug list

EYE, EAR, NOSE AND THROAT PREPARATIONS › OTHER EYE, EAR, NOSE AND THROAT AGENTS

DEXTRAN 70 & HYDROXYPROPYL METHYLCELLULOSE & POLYQUAD (Tears Naturale II)

0.1%/0.3%/0.001%Oph Sol

LU49

QUICK SCAN

For patients with objective evidence of keratoconjunctivitis sicca as confirmed by filamentary keratopathy on slit lamp examination or biopsy.

Complete Ontario criteria

For patients with objective evidence of keratoconjunctivitis sicca as confirmed by filamentary keratopathy on slit lamp examination or biopsy.