B-TRACIN 400UNT/HC 1%/N-MYCIN 3.5MG/POLYMYX 10000UNT/GM OINT,OPH (5953) VA PRODUCT (50.68)

Name	Value
NAME	B-TRACIN 400UNT/HC 1%/N-MYCIN 3.5MG/POLYMYX 10000UNT/GM OINT,OPH
VA GENERIC NAME	BACITRACIN/HYDROCORTISONE/NEOMYCIN/POLYMYXIN B
DOSAGE FORM	OINT,OPH
ACTIVE INGREDIENTS	HYDROCORTISONE STRENGTH: 1 UNITS: % POLYMYXIN B SULFATE BACITRACIN ZINC STRENGTH: 400 UNITS: UNIT/GM NEOMYCIN SULFATE
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	2
NATIONAL FORMULARY NAME	BACITRACIN/HYDROCORTISONE/NEOMYCIN/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
VA PRINT NAME	BACITRACIN/HC 1%/NEO/POLYMYX OPH OINT
VA PRODUCT IDENTIFIER	B0259
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	TUBE
MASTER ENTRY FOR VUID	YES
VUID	4006476
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE