| NAME |
METHYL AMINOLEVULINATE 16.8% CREAM,TOP |
| VA GENERIC NAME |
METHYL AMINOLEVULINATE |
| DOSAGE FORM |
CREAM,TOP |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
16.8 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| INACTIVATION DATE |
2016-06-15 00:00:00 |
| UNITS |
% |
| NATIONAL FORMULARY NAME |
METHYL AMINOLEVULINATE CREAM,TOP |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
METHYL AMINOLEVULINATE 16.8% TOP CREAM |
| VA PRODUCT IDENTIFIER |
M0862 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
GM |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4028661 |
| EFFECTIVE DATE/TIME |
-
- 2009-06-10 00:00:00
- STATUS: ACTIVE
|
