POUCH,RETRACTED PENIS H#9873 (14022)    VA PRODUCT (50.68)

Name Value
NAME POUCH,RETRACTED PENIS H#9873
VA GENERIC NAME BAG
DOSAGE FORM POUCH
CS FEDERAL SCHEDULE Unscheduled
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,RETRACTED PENIS H#9873
VA PRODUCT IDENTIFIER XY001
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4014386
EFFECTIVE DATE/TIME
  • 2003-03-17 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE