HC 1%/N-MYCIN 3.5MG/POLYMYX 10000UNT/ML SUSP,OPH (4887)    VA PRODUCT (50.68)

Name Value
NAME HC 1%/N-MYCIN 3.5MG/POLYMYX 10000UNT/ML SUSP,OPH
VA GENERIC NAME HYDROCORTISONE/NEOMYCIN/POLYMYXIN B
DOSAGE FORM SUSP,OPH
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
DSS NUMBER 2
NATIONAL FORMULARY NAME HYDROCORTISONE/NEOMYCIN/POLYMYXIN B SUSP,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 HC 1%/NEOMYCIN 3.5MG/POLYMYXIN OPH SUSP
VA PRODUCT IDENTIFIER H0104
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4005429
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2011-02-03 00:00:00
    STATUS:   INACTIVE
  • 2011-04-08 00:00:00
    STATUS:   ACTIVE