| NAME |
B-TRACIN 500UNT/N-MYCIN 5MG/POLYMYX 10000UNT/GM OINT,OPH |
| VA GENERIC NAME |
BACITRACIN/NEOMYCIN/POLYMYXIN B |
| DOSAGE FORM |
OINT,OPH |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2008-09-03 00:00:00 |
| DSS NUMBER |
1 |
| NATIONAL FORMULARY NAME |
BACITRACIN/NEOMYCIN/POLYMYXIN B OINT,OPH |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
BACITRACIN/NEOMYCIN/POLYMYXIN OPH OINT |
| VA PRODUCT IDENTIFIER |
B0247 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
TUBE |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4003546 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2008-09-03 00:00:00
- STATUS: INACTIVE
|