CAPSAICIN 0.03%/MENTHOL 4% PATCH (30668)    VA PRODUCT (50.68)

Name Value
NAME CAPSAICIN 0.03%/MENTHOL 4% PATCH
VA GENERIC NAME CAPSAICIN/MENTHOL
DOSAGE FORM PATCH
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME CAPSAICIN/MENTHOL PATCH
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2021-01-28 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME CAPSAICIN 0.03%/MENTHOL 4% PATCH
VA PRODUCT IDENTIFIER C1972
TRANSMIT TO CMOP NO
VA DISPENSE UNIT PATCH
MASTER ENTRY FOR VUID YES
VUID 4039983
EFFECTIVE DATE/TIME
  • 2021-01-28 00:00:00
    STATUS:   ACTIVE
  • 2021-01-28 00:00:00
    STATUS:   ACTIVE
  • 2021-01-28 00:00:00
    STATUS:   ACTIVE