LARYNGECTOMY TUBE PROVOX #8051 (31149)    VA PRODUCT (50.68)

Name Value
NAME LARYNGECTOMY TUBE PROVOX #8051
VA GENERIC NAME LARYNGEAL
DOSAGE FORM TUBE
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME LARYNGEAL TUBE
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-05-28 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME LARYNGECTOMY TUBE PROVOX #8051
VA PRODUCT IDENTIFIER XK692
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040500
EFFECTIVE DATE/TIME
  • 2021-05-28 00:00:00
    STATUS:   ACTIVE
  • 2021-05-28 00:00:00
    STATUS:   ACTIVE
  • 2021-05-28 00:00:00
    STATUS:   ACTIVE