MENTHOL 0.5%/PETROLATUM 30%/PRAMOXINE 1% CREAM,TOP (19389) VA PRODUCT (50.68)

Name	Value
NAME	MENTHOL 0.5%/PETROLATUM 30%/PRAMOXINE 1% CREAM,TOP
VA GENERIC NAME	MENTHOL/PETROLATUM/PRAMOXINE
DOSAGE FORM	CREAM,TOP
ACTIVE INGREDIENTS	PETROLATUM STRENGTH: 30 UNITS: % MENTHOL STRENGTH: 0.5 UNITS: % PRAMOXINE STRENGTH: 1 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	MENTHOL/PETROLATUM/PRAMOXINE CREAM,TOP
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	MENTHOL 0.5/PETRO/PRAMOXINE 1% TOP CREAM
VA PRODUCT IDENTIFIER	M0817
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4027264
EFFECTIVE DATE/TIME	2008-04-10 00:00:00 STATUS: ACTIVE