POUCH,DRAINABLE,PREMIER H#8961 (28610)    VA PRODUCT (50.68)

Name Value
NAME POUCH,DRAINABLE,PREMIER H#8961
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:   2018-07-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME POUCH,DRAINABLE,PREMIER H#8961
VA PRODUCT IDENTIFIER XJ364
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037640
EFFECTIVE DATE/TIME
  • 2018-07-02 00:00:00
    STATUS:   ACTIVE