B-TRACIN 400UNT/N-MYCIN 5MG/POLYMYX 5000UNT/GM OINT,OPH (2969) VA PRODUCT (50.68)

Name	Value
NAME	B-TRACIN 400UNT/N-MYCIN 5MG/POLYMYX 5000UNT/GM OINT,OPH
VA GENERIC NAME	BACITRACIN/NEOMYCIN/POLYMYXIN B
DOSAGE FORM	OINT,OPH
ACTIVE INGREDIENTS	POLYMYXIN B SULFATE STRENGTH: 5000 UNITS: UNIT/GM BACITRACIN ZINC STRENGTH: 400 UNITS: UNIT/GM NEOMYCIN SULFATE STRENGTH: 5 UNITS: MG/GM
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2011-08-03 00:00:00
DSS NUMBER	3
NATIONAL FORMULARY NAME	BACITRACIN/NEOMYCIN/POLYMYXIN B OINT,OPH
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	BACITRACIN/NEOMYCIN/POLYMYXIN OPH OINT
VA PRODUCT IDENTIFIER	B0247
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	TUBE
MASTER ENTRY FOR VUID	YES
VUID	4003548
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2011-08-03 00:00:00 STATUS: INACTIVE