HYDROCHLOROTHIAZIDE 12.5MG/IRBESARTAN 150MG TAB (13407)    VA PRODUCT (50.68)

Name Value
NAME HYDROCHLOROTHIAZIDE 12.5MG/IRBESARTAN 150MG TAB
VA GENERIC NAME HYDROCHLOROTHIAZIDE/IRBESARTAN
DOSAGE FORM TAB
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME HYDROCHLOROTHIAZIDE/IRBESARTAN TAB
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME HCTZ 12.5/IRBESARTAN 150MG TAB
VA PRODUCT IDENTIFIER H0372
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4013772
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE