HYDROCHLOROTHIAZIDE 12.5MG/MOEXIPRIL HCL 15MG TAB (16953) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCHLOROTHIAZIDE 12.5MG/MOEXIPRIL HCL 15MG TAB
VA GENERIC NAME	HYDROCHLOROTHIAZIDE/MOEXIPRIL
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	HYDROCHLOROTHIAZIDE STRENGTH: 12.5 UNITS: MG MOEXIPRIL HYDROCHLORIDE STRENGTH: 15 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	HYDROCHLOROTHIAZIDE/MOEXIPRIL 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/MOEXIPRIL HCL 15MG TAB
VA PRODUCT IDENTIFIER	H0453
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4017316
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE