POUCH,UROSTOMY,PREMIER H#84699 (29019)    VA PRODUCT (50.68)

Name Value
NAME POUCH,UROSTOMY,PREMIER H#84699
VA GENERIC NAME POUCH,UROSTOMY
DOSAGE FORM POUCH
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME POUCH,UROSTOMY POUCH
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2019-01-30 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME POUCH,UROSTOMY,PREMIER H#84699
VA PRODUCT IDENTIFIER XJ550
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4038132
EFFECTIVE DATE/TIME
  • 2019-02-01 00:00:00
    STATUS:   ACTIVE