POUCH,RETRACTED PENIS H#9811 (11860)    VA PRODUCT (50.68)

Name Value
NAME POUCH,RETRACTED PENIS H#9811
VA GENERIC NAME BAG
DOSAGE FORM POUCH
CS FEDERAL SCHEDULE Unscheduled
DSS NUMBER 36
NATIONAL FORMULARY NAME BAG 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 H#9811
VA PRODUCT IDENTIFIER XP057
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4012226
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE