MENTHOL 1%/PRAMOXINE 1% CREAM (26572) VA PRODUCT (50.68)

Name	Value
NAME	MENTHOL 1%/PRAMOXINE 1% CREAM
VA GENERIC NAME	MENTHOL/PRAMOXINE
DOSAGE FORM	CREAM
ACTIVE INGREDIENTS	MENTHOL STRENGTH: 1 UNITS: % PRAMOXINE HYDROCHLORIDE STRENGTH: 1 UNITS: %
NATIONAL FORMULARY NAME	MENTHOL/PRAMOXINE CREAM
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 1%/PRAMOXINE 1% CREAM
VA PRODUCT IDENTIFIER	M1124
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4035406
EFFECTIVE DATE/TIME	2016-02-17 00:00:00 STATUS: ACTIVE