Product Details
Jamp-Amitriptyline
Amitriptyline25 mg
Tablet
DIN/PIN/NPN
02457695
Manufacturer
Jamp Pharma Corporation
Formulary Listing Date
2025-12-30
Unit Price
0.0580
Amount MOH Pays
0.0580
Coverage Status
General Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N06AA09
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 00654515 | PMS-Amitriptyline | 0.0580 | 0.0580 |
| 02429888 | Mar-Amitriptyline | 0.0580 | 0.0580 |
| 00335061 | Elavil | 0.1211 | 0.0580 |
| 02457695 | Jamp-Amitriptyline | 0.0580 | 0.0580 |
LU Clinical Criteria
NORequirements