NON-ADHESIVE UROSTOMY SYSTEM MED #501001 (11927)    VA PRODUCT (50.68)

Name Value
NAME NON-ADHESIVE UROSTOMY SYSTEM MED #501001
VA GENERIC NAME UROSTOMY SYSTEM
DOSAGE FORM POUCH
CS FEDERAL SCHEDULE Unscheduled
DSS NUMBER 1
NATIONAL FORMULARY NAME UROSTOMY SYSTEM 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 NON-ADHESIVE UROSTOMY SYSTEM MED #501001
VA PRODUCT IDENTIFIER XN001
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4012293
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE