Product Details
Jamp-Amitriptyline
Amitriptyline50 mg
Tablet
DIN/PIN/NPN
02457687
Manufacturer
Jamp Pharma Corporation
Formulary Listing Date
2025-12-30
Unit Price
0.1078
Amount MOH Pays
0.1078
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 |
|---|---|---|---|
| 00654507 | PMS-Amitriptyline | 0.1078 | 0.1078 |
| 02429896 | Mar-Amitriptyline | 0.1078 | 0.1078 |
| 00335088 | Elavil | 0.2347 | 0.1078 |
| 02457687 | Jamp-Amitriptyline | 0.1078 | 0.1078 |
LU Clinical Criteria
NORequirements