TRACH TUBE,SZ 4 CUFFLESS SHLY #4-UN65H (28881)    VA PRODUCT (50.68)

Name Value
NAME TRACH TUBE,SZ 4 CUFFLESS SHLY #4-UN65H
VA GENERIC NAME TRACHEOSTOMY
DOSAGE FORM TUBE
NATIONAL FORMULARY NAME TRACHEOSTOMY TUBE
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-11-02 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME TRACH TUBE,SZ 4 CUFFLESS SHLY #4-UN65H
VA PRODUCT IDENTIFIER XJ492
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037961
EFFECTIVE DATE/TIME
  • 2018-11-02 00:00:00
    STATUS:   ACTIVE