POUCH,UROSTOMY,ACTIVE LIFE C#1757-97 (10884)    VA PRODUCT (50.68)

Name Value
NAME POUCH,UROSTOMY,ACTIVE LIFE C#1757-97
VA GENERIC NAME POUCH,UROSTOMY
DOSAGE FORM POUCH
CS FEDERAL SCHEDULE Unscheduled
DSS NUMBER 33
NATIONAL FORMULARY NAME POUCH,UROSTOMY POUCH
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME POUCH,UROSTOMY,ACTIVE LIFE C#1757-97
VA PRODUCT IDENTIFIER XS527
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4011257
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE