LARYNGECTOMY TUBE PROVOX #7643 (25437)    VA PRODUCT (50.68)

Name Value
NAME LARYNGECTOMY TUBE PROVOX #7643
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 #7643
VA PRODUCT IDENTIFIER XH912
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4034158
EFFECTIVE DATE/TIME
  • 2015-02-13 00:00:00
    STATUS:   ACTIVE