B-TRACIN 400UNT/HC 1%/N-MYCIN 3.5MG/POLYMYX 10000UNT/ML SUSP,OPH (5957) VA PRODUCT (50.68)

Name	Value
NAME	B-TRACIN 400UNT/HC 1%/N-MYCIN 3.5MG/POLYMYX 10000UNT/ML SUSP,OPH
VA GENERIC NAME	BACITRACIN/HYDROCORTISONE/NEOMYCIN/POLYMYXIN B
DOSAGE FORM	SUSP,OPH
ACTIVE INGREDIENTS	NEOMYCIN (AS SULFATE) STRENGTH: 0.35 UNITS: % HYDROCORTISONE STRENGTH: 10 UNITS: MG POLYMYXIN B SULFATE STRENGTH: 10000 UNITS: UNIT BACITRACIN ZINC STRENGTH: 400 UNITS: UNIT
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	6
NATIONAL FORMULARY NAME	BACITRACIN/HYDROCORTISONE/NEOMYCIN/POLYMYXIN B 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	BACITRACIN/HC 1%/NEO/POLYMYX OPH SUSP
VA PRODUCT IDENTIFIER	B0258
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4006480
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE