RESPIRATORY TUBING 22MM PASSIVE CIRCUT RESPIRONICS #1147378 (31828)    VA PRODUCT (50.68)

Name Value
NAME RESPIRATORY TUBING 22MM PASSIVE CIRCUT RESPIRONICS #1147378
VA GENERIC NAME TUBE
DOSAGE FORM MISCELLANEOUS
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME TUBE MISCELLANEOUS
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2022-03-22 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME RESPIRATORY TUBE 22MM PASSIVE R#1147378
VA PRODUCT IDENTIFIER XL111
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4041270
EFFECTIVE DATE/TIME
  • 2022-03-22 00:00:00
    STATUS:   ACTIVE