ACETIC AC/BENZALKONIUM CL/CHLOROXYLENOL/HC 1%/PRAMOXINE SLN,OTIC (7543) VA PRODUCT (50.68)

Name	Value
NAME	ACETIC AC/BENZALKONIUM CL/CHLOROXYLENOL/HC 1%/PRAMOXINE SLN,OTIC
VA GENERIC NAME	ACETIC/BENZALKONIUM/CHLOROXYLENOL/HYDROCORTISONE/PRAMOXINE
DOSAGE FORM	SOLN,OTIC
ACTIVE INGREDIENTS	ACETIC ACID,GLACIAL STRENGTH: 2 UNITS: % PROPYLENE GLYCOL UNITS: QS CHLOROXYLENOL STRENGTH: 0.1 UNITS: % HYDROCORTISONE STRENGTH: 1 UNITS: % PRAMOXINE HYDROCHLORIDE STRENGTH: 1 UNITS: % BENZALKONIUM CHLORIDE STRENGTH: 0.02 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-28 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	ACETIC/BENZALKONIUM/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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4008046
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-28 00:00:00 STATUS: INACTIVE