TRACH BASEPLATE ADHESIVE PROVOX #7462 (31084)    VA PRODUCT (50.68)

Name Value
NAME TRACH BASEPLATE ADHESIVE PROVOX #7462
VA GENERIC NAME TRACHEOSTOMY ADHESIVE
DOSAGE FORM MISCELLANEOUS
HAZARDOUS TO DISPOSE NO
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 #7462
VA PRODUCT IDENTIFIER XK647
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040438
EFFECTIVE DATE/TIME
  • 2021-05-06 00:00:00
    STATUS:   ACTIVE
  • 2021-05-06 00:00:00
    STATUS:   ACTIVE
  • 2021-05-06 00:00:00
    STATUS:   ACTIVE