HYDROCORTISONE 1.5%/OXYTETRACYCLINE 5MG/ML SUSP,OPH (5136)    VA PRODUCT (50.68)

Name Value
NAME HYDROCORTISONE 1.5%/OXYTETRACYCLINE 5MG/ML SUSP,OPH
VA GENERIC NAME HYDROCORTISONE/OXYTETRACYCLINE
DOSAGE FORM SUSP,OPH
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2003-08-01 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME HYDROCORTISONE/OXYTETRACYCLINE 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 1.5%/OXYTETRACYCLINE 5MG/ML OPH SUSP
VA PRODUCT IDENTIFIER H0106
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4005677
EFFECTIVE DATE/TIME
  • 2003-08-01 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE