GRAMICIDIN 0.025MG/N-MYCIN 2.5MG/POLYMYX 10000UNT/ML SOLN,OPH (5981) VA PRODUCT (50.68)

Name	Value
NAME	GRAMICIDIN 0.025MG/N-MYCIN 2.5MG/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: 2.5 UNITS: MG/ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2009-11-17 00:00:00
DSS NUMBER	2
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 2.5MG/POLYMXIN OPH SOLN
VA PRODUCT IDENTIFIER	G0069
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4006503
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2009-11-17 00:00:00 STATUS: INACTIVE