MENTHOL 4% GEL,TOP (29501)    VA PRODUCT (50.68)

Name Value
NAME MENTHOL 4% GEL,TOP
VA GENERIC NAME MENTHOL
DOSAGE FORM GEL,TOP
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR TEXT 
Not supplied by pharmacy for inpatient use.
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 4
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS %
NATIONAL FORMULARY NAME MENTHOL GEL,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2019-09-06 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME MENTHOL 4% TOP GEL
VA PRODUCT IDENTIFIER M1222
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4038679
EFFECTIVE DATE/TIME
  • 2019-09-06 00:00:00
    STATUS:   ACTIVE
  • 2019-09-06 00:00:00
    STATUS:   ACTIVE
  • 2019-09-06 00:00:00
    STATUS:   ACTIVE