POUCH,UROSTOMY,PREMIER H#84494 (30452)    VA PRODUCT (50.68)

Name Value
NAME POUCH,UROSTOMY,PREMIER H#84494
VA GENERIC NAME POUCH,UROSTOMY
DOSAGE FORM POUCH
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME POUCH,UROSTOMY POUCH
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2020-10-15 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME POUCH,UROSTOMY,PREMIER H#84494
VA PRODUCT IDENTIFIER XK248
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4039751
EFFECTIVE DATE/TIME
  • 2020-10-16 00:00:00
    STATUS:   ACTIVE
  • 2020-10-16 00:00:00
    STATUS:   ACTIVE
  • 2020-10-16 00:00:00
    STATUS:   ACTIVE