LARYNGEAL PROSTHESIS,PROVOX #8122 (23381)    VA PRODUCT (50.68)

Name Value
NAME LARYNGEAL PROSTHESIS,PROVOX #8122
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,PROVOX #8122
VA PRODUCT IDENTIFIER XH051
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4031837
EFFECTIVE DATE/TIME
  • 2012-12-18 00:00:00
    STATUS:   ACTIVE