LARYNGECTOMY TUBE PROVOX #7607 (25155)    VA PRODUCT (50.68)

Name Value
NAME LARYNGECTOMY TUBE PROVOX #7607
VA GENERIC NAME LARYNGEAL
DOSAGE FORM TUBE
NATIONAL FORMULARY NAME LARYNGEAL TUBE
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 LARYNGECTOMY TUBE PROVOX #7607
VA PRODUCT IDENTIFIER XH779
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4033836
EFFECTIVE DATE/TIME
  • 2014-11-18 00:00:00
    STATUS:   ACTIVE