MENTHOL 0.12%/PHENOL 1.45% LOZENGE (9299) VA PRODUCT (50.68)

Name	Value
NAME	MENTHOL 0.12%/PHENOL 1.45% LOZENGE
VA GENERIC NAME	MENTHOL/PHENOL
DOSAGE FORM	LOZENGE
ACTIVE INGREDIENTS	MENTHOL STRENGTH: 0.12 UNITS: % EUCALYPTUS OIL SACCHARIN SODIUM CARAMEL PHENOL STRENGTH: 1.45 UNITS: % ANTIFOAM EMULSION GUM CRYSTAL MANNITOL SORBITOL
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2011-07-08 00:00:00
DSS NUMBER	3
NATIONAL FORMULARY NAME	MENTHOL/PHENOL LOZENGE
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	THROAT LOZENGE
VA PRODUCT IDENTIFIER	T0047
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	LOZ
MASTER ENTRY FOR VUID	YES
VUID	4009725
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2011-07-08 00:00:00 STATUS: INACTIVE