HC 1%/N-MYCIN 5MG/POLYMYX 10000UNT/ML SUSP,OTIC (4888)    VA PRODUCT (50.68)

Name Value
NAME HC 1%/N-MYCIN 5MG/POLYMYX 10000UNT/ML SUSP,OTIC
VA GENERIC NAME HYDROCORTISONE/NEOMYCIN/POLYMYXIN B
DOSAGE FORM SUSP,OTIC
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2000-03-16 00:00:00
DSS NUMBER 3
NATIONAL FORMULARY NAME HYDROCORTISONE/NEOMYCIN/POLYMYXIN B SUSP,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 HC 1%/NEOMYCIN 3.5MG/POLYMYXIN OTIC SUSP
VA PRODUCT IDENTIFIER H0023
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4005430
EFFECTIVE DATE/TIME
  • 2000-03-16 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE