MENTHOL 1.25% SPRAY,TOP (28518)    VA PRODUCT (50.68)

Name Value
NAME MENTHOL 1.25% SPRAY,TOP
VA GENERIC NAME MENTHOL
DOSAGE FORM SPRAY,TOP
FORMULARY DESIGNATOR TEXT 
Not supplied by pharmacy for inpatient use.
ACTIVE INGREDIENTS
  • MENTHOL
    STRENGTH:   1.25
    UNITS:   %
STRENGTH 1.25
UNITS %
NATIONAL FORMULARY NAME MENTHOL SPRAY,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2018-06-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME MENTHOL 1.25% TOP SPRAY
VA PRODUCT IDENTIFIER M1187
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4037532
EFFECTIVE DATE/TIME
  • 2018-05-11 00:00:00
    STATUS:   ACTIVE