| Name | Value |
|---|---|
| NAME | LARYNGECTOMY TUBE PROVOX #7415 |
| VA GENERIC NAME | LARYNGEAL |
| DOSAGE FORM | TUBE |
| HAZARDOUS TO DISPOSE | NO |
| NATIONAL FORMULARY NAME | LARYNGEAL TUBE |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| VA PRINT NAME | LARYNGECTOMY TUBE PROVOX #7415 |
| VA PRODUCT IDENTIFIER | XL403 |
| TRANSMIT TO CMOP | NO |
| VA DISPENSE UNIT | EA |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4041896 |
| EFFECTIVE DATE/TIME |
|