CHLORTHALIDONE 15MG TAB (2077)    VA PRODUCT (50.68)

Name Value
NAME CHLORTHALIDONE 15MG TAB
VA GENERIC NAME CHLORTHALIDONE
DOSAGE FORM TAB
ACTIVE INGREDIENTS
NATIONAL FORMULARY RESTRICTION 
Refer to VA/DoD Hypertension treatment and PBM/MAP CHF treatment guidelines
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 15
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2020-01-15 00:00:00
UNITS MG
DSS NUMBER 4
NATIONAL FORMULARY NAME CHLORTHALIDONE 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 CHLORTHALIDONE 15MG TAB
VA PRODUCT IDENTIFIER C0761
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4002660
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2020-01-15 00:00:00
    STATUS:   INACTIVE