OXYTETRACYCLINE 5MG/POLYMYXIN B SO4 10000UNT/GM OINT,OPH (5147) VA PRODUCT (50.68)

Name	Value
NAME	OXYTETRACYCLINE 5MG/POLYMYXIN B SO4 10000UNT/GM OINT,OPH
VA GENERIC NAME	OXYTETRACYCLINE/POLYMYXIN B
DOSAGE FORM	OINT,OPH
ACTIVE INGREDIENTS	OXYTETRACYCLINE HYDROCHLORIDE STRENGTH: 0.5 UNITS: % POLYMYXIN B SULFATE STRENGTH: 10000 UNITS: UNIT/GM
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	1
NATIONAL FORMULARY NAME	OXYTETRACYCLINE/POLYMYXIN B OINT,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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4005688
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE