GRAMICIDIN 0.025MG/N-MYCIN 1.75MG/POLYMYX 10000UNT/ML SOLN,OPH (5980) VA PRODUCT (50.68)

Name	Value
NAME	GRAMICIDIN 0.025MG/N-MYCIN 1.75MG/POLYMYX 10000UNT/ML SOLN,OPH
VA GENERIC NAME	GRAMICIDIN/NEOMYCIN/POLYMYXIN B
DOSAGE FORM	SOLN,OPH
ACTIVE INGREDIENTS	GRAMICIDIN STRENGTH: 0.025 UNITS: MG/ML POLYMYXIN B SULFATE STRENGTH: 10000 UNITS: UNIT/ML NEOMYCIN SULFATE STRENGTH: 1.75 UNITS: MG/ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	1
NATIONAL FORMULARY NAME	GRAMICIDIN/NEOMYCIN/POLYMYXIN B SOLN,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	GRAMICIDIN/NEO 1.75MG/POLYMXIN OPH SOLN
VA PRODUCT IDENTIFIER	G0030
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4006502
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE