TRACH FILTER FOAM ADDVOX #TR1115 (26730)    VA PRODUCT (50.68)

Name Value
NAME TRACH FILTER FOAM ADDVOX #TR1115
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 ADDVOX #TR1115
VA PRODUCT IDENTIFIER XI481
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4035568
EFFECTIVE DATE/TIME
  • 2016-03-29 00:00:00
    STATUS:   ACTIVE