POUCH,DRAINABLE,PREMIER H#8292 (27474)    VA PRODUCT (50.68)

Name Value
NAME POUCH,DRAINABLE,PREMIER H#8292
VA GENERIC NAME POUCH,OSTOMY
DOSAGE FORM POUCH
NATIONAL FORMULARY NAME POUCH,OSTOMY POUCH
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-04-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME POUCH,DRAINABLE,PREMIER H#8292
VA PRODUCT IDENTIFIER XI839
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4036386
EFFECTIVE DATE/TIME
  • 2017-02-07 00:00:00
    STATUS:   ACTIVE