POUCH,UROSTOMY,PREMIER H#8478 (10975)    VA PRODUCT (50.68)

Name Value
NAME POUCH,UROSTOMY,PREMIER H#8478
VA GENERIC NAME POUCH,UROSTOMY
DOSAGE FORM POUCH
CS FEDERAL SCHEDULE Unscheduled
DSS NUMBER 124
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,PREMIER H#8478
VA PRODUCT IDENTIFIER XP091
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4011348
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE