LARYNGEAL PROSTHESIS,BLOM-SINGER LP20012 (22864)    VA PRODUCT (50.68)

Name Value
NAME LARYNGEAL PROSTHESIS,BLOM-SINGER LP20012
VA GENERIC NAME LARYNGEAL
DOSAGE FORM DEVICE
NATIONAL FORMULARY NAME LARYNGEAL DEVICE
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME LARYNGEAL PROSTHESIS,BLOM-SINGER LP20012
VA PRODUCT IDENTIFIER XR203
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4031239
EFFECTIVE DATE/TIME
  • 2012-02-06 00:00:00
    STATUS:   ACTIVE