AMLODIPINE 5MG/HYDROCHLOROTHIAZIDE 25MG/OLMESARTAN 40MG TAB (21881) VA PRODUCT (50.68)

Name	Value
NAME	AMLODIPINE 5MG/HYDROCHLOROTHIAZIDE 25MG/OLMESARTAN 40MG TAB
VA GENERIC NAME	AMLODIPINE/HYDROCHLOROTHIAZIDE/OLMESARTAN
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	HYDROCHLOROTHIAZIDE STRENGTH: 25 UNITS: MG AMLODIPINE STRENGTH: 5 UNITS: MG OLMESARTAN MEDOXOMIL STRENGTH: 40 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	AMLODIPINE/HYDROCHLOROTHIAZIDE/OLMESARTAN 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	AMLODIPINE 5/HCTZ 25/OLMESARTAN 40MG TAB
VA PRODUCT IDENTIFIER	A1553
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4030080
EFFECTIVE DATE/TIME	2010-09-08 00:00:00 STATUS: ACTIVE