POUCH,DRAINABLE,PREMIER H#82628 (32527)    VA PRODUCT (50.68)

Name Value
NAME POUCH,DRAINABLE,PREMIER H#82628
VA GENERIC NAME POUCH,OSTOMY
DOSAGE FORM POUCH
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME POUCH,OSTOMY POUCH
CREATE DEFAULT POSSIBLE DOSAGE YES
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2023-02-23 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME POUCH,DRAINABLE,PREMIER H#82628
VA PRODUCT IDENTIFIER XL469
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4042047
EFFECTIVE DATE/TIME
  • 2023-02-23 00:00:00
    STATUS:   ACTIVE