POUCH,OSTOMY,ACTIVE LIFE C#1253-33 (31939)    VA PRODUCT (50.68)

Name Value
NAME POUCH,OSTOMY,ACTIVE LIFE C#1253-33
VA GENERIC NAME POUCH
DOSAGE FORM POUCH
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME POUCH POUCH
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2022-05-11 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME POUCH,OSTOMY,ACTIVE LIFE C#1253-33
VA PRODUCT IDENTIFIER XL178
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4041386
EFFECTIVE DATE/TIME
  • 2022-05-11 00:00:00
    STATUS:   ACTIVE