HC 1%/N-MYCIN 3.5MG/POLYMYX 10000UNT/ML SOLN,OTIC (4890) VA PRODUCT (50.68)

Name	Value
NAME	HC 1%/N-MYCIN 3.5MG/POLYMYX 10000UNT/ML SOLN,OTIC
VA GENERIC NAME	HYDROCORTISONE/NEOMYCIN/POLYMYXIN B
DOSAGE FORM	SOLN,OTIC
ACTIVE INGREDIENTS	HYDROCORTISONE STRENGTH: 1 UNITS: % POLYMYXIN B SULFATE STRENGTH: 10000 UNITS: UNIT/ML NEOMYCIN SULFATE STRENGTH: 3.5 UNITS: MG/ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	5
NATIONAL FORMULARY NAME	HYDROCORTISONE/NEOMYCIN/POLYMYXIN B 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	HC 1%/NEOMYCIN 3.5MG/POLYMYXIN OTIC SOLN
VA PRODUCT IDENTIFIER	H0022
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4005432
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE