ADAPTOR,TRACH BASEPLATE PROVOX #7263 (30573)    VA PRODUCT (50.68)

Name Value
NAME ADAPTOR,TRACH BASEPLATE PROVOX #7263
VA GENERIC NAME TRACHEOSTOMY
DOSAGE FORM DEVICE
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME TRACHEOSTOMY DEVICE
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2020-12-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME ADAPTOR,TRACH BASEPLATE PROVOX #7263
VA PRODUCT IDENTIFIER XK300
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4039876
EFFECTIVE DATE/TIME
  • 2020-12-01 00:00:00
    STATUS:   ACTIVE
  • 2020-12-01 00:00:00
    STATUS:   ACTIVE
  • 2020-12-01 00:00:00
    STATUS:   ACTIVE