TRACH STOMA BUTTON PROVOX #7672 (24767)    VA PRODUCT (50.68)

Name Value
NAME TRACH STOMA BUTTON PROVOX #7672
VA GENERIC NAME TRACHEOSTOMY
DOSAGE FORM MISCELLANEOUS
NATIONAL FORMULARY NAME TRACHEOSTOMY 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 STOMA BUTTON PROVOX #7672
VA PRODUCT IDENTIFIER XH641
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4033394
EFFECTIVE DATE/TIME
  • 2014-06-17 00:00:00
    STATUS:   ACTIVE