LARYNGECTOMY TUBE PROVOX #7602 (25745)    VA PRODUCT (50.68)

Name Value
NAME LARYNGECTOMY TUBE PROVOX #7602
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 #7602
VA PRODUCT IDENTIFIER XI059
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4034495
EFFECTIVE DATE/TIME
  • 2015-05-28 00:00:00
    STATUS:   ACTIVE