COLISTIN 3MG/HC 1%/N-MYCIN 3.3MG/THONZONIUM 0.5MG/ML SUSP,OTIC (12864) VA PRODUCT (50.68)

Name	Value
NAME	COLISTIN 3MG/HC 1%/N-MYCIN 3.3MG/THONZONIUM 0.5MG/ML SUSP,OTIC
VA GENERIC NAME	COLISTIN/HYDROCORTISONE/NEOMYCIN/THONZONIUM
DOSAGE FORM	SUSP,OTIC
ACTIVE INGREDIENTS	COLISTIN SULFATE STRENGTH: 3 UNITS: MG/ML THONZONIUM BROMIDE STRENGTH: 0.5 UNITS: MG/ML NEOMYCIN (AS SULFATE) STRENGTH: 3.3 UNITS: MG/ML HYDROCORTISONE ACETATE STRENGTH: 1 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	1
NATIONAL FORMULARY NAME	COLISTIN/HYDROCORTISONE/NEOMYCIN/THONZONIUM SUSP,OTIC
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	COLISTIN/HC/N-MYCIN/THONZONIUM OTIC SUSP
VA PRODUCT IDENTIFIER	C1447
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4013229
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2010-05-05 00:00:00 STATUS: INACTIVE 2010-08-13 00:00:00 STATUS: ACTIVE