| NAME |
TRACH STOMA PROTECTOR,FOAM 2.75IN X 2.75IN PROVOX #1433H |
| VA GENERIC NAME |
TRACHEOSTOMY |
| DOSAGE FORM |
MISCELLANEOUS |
| HAZARDOUS TO DISPOSE |
NO |
| NATIONAL FORMULARY NAME |
TRACHEOSTOMY MISCELLANEOUS |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2020-04-29 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
TRACH STOMA PROTECTOR 2.75X2.75IN #1433H |
| VA PRODUCT IDENTIFIER |
XK067 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4039356 |
| EFFECTIVE DATE/TIME |
-
- 2020-04-30 00:00:00
- STATUS: ACTIVE
|
