POUCH,CLOSED POUCHKINS H#3778 (18103)    VA PRODUCT (50.68)

Name Value
NAME POUCH,CLOSED POUCHKINS H#3778
VA GENERIC NAME POUCH,OSTOMY
DOSAGE FORM POUCH
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME POUCH COVER 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,CLOSED POUCHKINS H#3778
VA PRODUCT IDENTIFIER XV214
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4025834
EFFECTIVE DATE/TIME
  • 2007-01-25 00:00:00
    STATUS:   ACTIVE