HYDROCHLOROTHIAZIDE 25MG/PROPRANOLOL HCL 80MG TAB (4450) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCHLOROTHIAZIDE 25MG/PROPRANOLOL HCL 80MG TAB
VA GENERIC NAME	HYDROCHLOROTHIAZIDE/PROPRANOLOL
DOSAGE FORM	TAB
ACTIVE INGREDIENTS	HYDROCHLOROTHIAZIDE STRENGTH: 25 UNITS: MG PROPRANOLOL HYDROCHLORIDE STRENGTH: 80 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	5
NATIONAL FORMULARY NAME	HYDROCHLOROTHIAZIDE/PROPRANOLOL 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 25/PROPRANOLOL 80MG TAB
VA PRODUCT IDENTIFIER	H0133
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4004997
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE