HC 0.5%/N-MYCIN 5MG/POLYMYX 10000UNT/GM CREAM,TOP (4892) VA PRODUCT (50.68)

Name	Value
NAME	HC 0.5%/N-MYCIN 5MG/POLYMYX 10000UNT/GM CREAM,TOP
VA GENERIC NAME	HYDROCORTISONE/NEOMYCIN/POLYMYXIN B
DOSAGE FORM	CREAM,TOP
ACTIVE INGREDIENTS	HYDROCORTISONE ACETATE STRENGTH: 0.5 UNITS: % POLYMYXIN B SULFATE STRENGTH: 10000 UNITS: UNIT/GM NEOMYCIN SULFATE STRENGTH: 5 UNITS: MG/GM
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2021-07-15 00:00:00
DSS NUMBER	7
NATIONAL FORMULARY NAME	HYDROCORTISONE/NEOMYCIN/POLYMYXIN B CREAM,TOP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00 COPAY END DATE: 2021-05-19 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2021-05-20 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	HC 0.5%/NEOMYCIN 5MG/POLYMYXIN CREAM
VA PRODUCT IDENTIFIER	H0098
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4005434
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2021-07-15 00:00:00 STATUS: INACTIVE 2021-07-15 00:00:00 STATUS: INACTIVE 2021-07-15 00:00:00 STATUS: INACTIVE