TRACH BASEPLATE ADHESIVE PROVOX #7640 (31082)    VA PRODUCT (50.68)

Name Value
NAME TRACH BASEPLATE ADHESIVE PROVOX #7640
VA GENERIC NAME TRACHEOSTOMY ADHESIVE
DOSAGE FORM MISCELLANEOUS
HAZARDOUS TO DISPOSE NO
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2021-07-01 00:00:00
NATIONAL FORMULARY NAME TRACHEOSTOMY ADHESIVE MISCELLANEOUS
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-05-05 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME TRACH BASEPLATE ADHESIVE PROVOX #7640
VA PRODUCT IDENTIFIER XK653
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040447
EFFECTIVE DATE/TIME
  • 2021-05-06 00:00:00
    STATUS:   ACTIVE
  • 2021-07-01 00:00:00
    STATUS:   INACTIVE
  • 2021-05-06 00:00:00
    STATUS:   ACTIVE
  • 2021-07-01 00:00:00
    STATUS:   INACTIVE
  • 2021-07-01 00:00:00
    STATUS:   INACTIVE
  • 2021-05-06 00:00:00
    STATUS:   ACTIVE
  • 2021-07-01 00:00:00
    STATUS:   INACTIVE