TRACH BASEPLATE ADHESIVE PROVOX #7461 (31273)    VA PRODUCT (50.68)

Name Value
NAME TRACH BASEPLATE ADHESIVE PROVOX #7461
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:   2021-07-07 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME TRACH BASEPLATE ADHESIVE PROVOX #7461
VA PRODUCT IDENTIFIER XK768
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040639
EFFECTIVE DATE/TIME
  • 2021-07-07 00:00:00
    STATUS:   ACTIVE
  • 2021-07-07 00:00:00
    STATUS:   ACTIVE
  • 2021-07-07 00:00:00
    STATUS:   ACTIVE