TRACH FILTER FOAM LARYNGEAL 2IN X 2.5IN KAPITEX #LD63019 (23439)    VA PRODUCT (50.68)

Name Value
NAME TRACH FILTER FOAM LARYNGEAL 2IN X 2.5IN KAPITEX #LD63019
VA GENERIC NAME FILTER
DOSAGE FORM MISCELLANEOUS
NATIONAL FORMULARY NAME FILTER MISCELLANEOUS
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 TRACH FILTER FOAM 2IN X 2.5IN #LD63019
VA PRODUCT IDENTIFIER XH099
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4031896
EFFECTIVE DATE/TIME
  • 2012-12-19 00:00:00
    STATUS:   ACTIVE