MENTHOL 16% SPRAY,TOP (29320)    VA PRODUCT (50.68)

Name Value
NAME MENTHOL 16% SPRAY,TOP
VA GENERIC NAME MENTHOL
DOSAGE FORM SPRAY,TOP
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR TEXT 
Not supplied by pharmacy for inpatient use.
ACTIVE INGREDIENTS
STRENGTH 16
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:   2019-06-17 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME MENTHOL 16% TOP SPRAY
VA PRODUCT IDENTIFIER M1212
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4038465
EFFECTIVE DATE/TIME
  • 2019-06-18 00:00:00
    STATUS:   ACTIVE
  • 2019-06-18 00:00:00
    STATUS:   ACTIVE