CHLOROXYLENOL 0.1%/HC 1%/PRAMOXINE 1% SOLN,OTIC (6846) VA PRODUCT (50.68)

Name	Value
NAME	CHLOROXYLENOL 0.1%/HC 1%/PRAMOXINE 1% SOLN,OTIC
VA GENERIC NAME	CHLOROXYLENOL/HYDROCORTISONE/PRAMOXINE
DOSAGE FORM	SOLN,OTIC
ACTIVE INGREDIENTS	CHLOROXYLENOL STRENGTH: 0.1 UNITS: % HYDROCORTISONE STRENGTH: 1 UNITS: % PRAMOXINE HYDROCHLORIDE STRENGTH: 1 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
DSS NUMBER	1
NATIONAL FORMULARY NAME	CHLOROXYLENOL/HYDROCORTISONE/PRAMOXINE SOLN,OTIC
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	CHLOROXYLENOL/HC 1%/PRAMOXINE OTIC SOLN
VA PRODUCT IDENTIFIER	C0400
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4007360
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE