POUCH,OSTOMY,ACTIVE LIFE C#4005-98 (14517)    VA PRODUCT (50.68)

Name Value
NAME POUCH,OSTOMY,ACTIVE LIFE C#4005-98
VA GENERIC NAME POUCH
DOSAGE FORM POUCH
NATIONAL FORMULARY NAME POUCH 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,OSTOMY,ACTIVE LIFE C#4005-98
VA PRODUCT IDENTIFIER XY310
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4014881
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE