LARYNGEAL PROSTHESIS,PROVOX #8273 (31065)    VA PRODUCT (50.68)

Name Value
NAME LARYNGEAL PROSTHESIS,PROVOX #8273
VA GENERIC NAME LARYNGEAL
DOSAGE FORM DEVICE
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME LARYNGEAL DEVICE
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-04-30 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME LARYNGEAL PROSTHESIS,PROVOX #8273
VA PRODUCT IDENTIFIER XK635
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040406
EFFECTIVE DATE/TIME
  • 2021-04-30 00:00:00
    STATUS:   ACTIVE
  • 2021-04-30 00:00:00
    STATUS:   ACTIVE
  • 2021-04-30 00:00:00
    STATUS:   ACTIVE