ANTIPYRINE 5.5%/BENZOCAINE 1.4%/GLYCERIN SOLN,OTIC (25307) VA PRODUCT (50.68)

Name	Value
NAME	ANTIPYRINE 5.5%/BENZOCAINE 1.4%/GLYCERIN SOLN,OTIC
VA GENERIC NAME	ANTIPYRINE/BENZOCAINE/GLYCERIN
DOSAGE FORM	SOLN,OTIC
ACTIVE INGREDIENTS	ANTIPYRINE STRENGTH: 5.5 UNITS: % BENZOCAINE STRENGTH: 1.4 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
INACTIVATION DATE	2016-02-17 00:00:00
NATIONAL FORMULARY NAME	ANTIPYRINE/BENZOCAINE/GLYCERIN SOLN,OTIC
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	ANTIPYRINE 5.5/BENZOCAINE 1.4% OTIC SOLN
VA PRODUCT IDENTIFIER	A1778
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4034005
EFFECTIVE DATE/TIME	2014-12-29 00:00:00 STATUS: ACTIVE