NORTRIPTYLINE HCL 75MG CAP (604)    VA PRODUCT (50.68)

Name Value
NAME NORTRIPTYLINE HCL 75MG CAP
VA GENERIC NAME NORTRIPTYLINE
DOSAGE FORM CAP,ORAL
FDA MED GUIDE Nortriptyline_(Generic)_(2017).pdf
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 75
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
DSS NUMBER 2
NATIONAL FORMULARY NAME NORTRIPTYLINE CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Both Inpatient and Outpatient
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   1
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
    COPAY END DATE:   2017-12-31 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2018-01-01 00:00:00
VA PRINT NAME NORTRIPTYLINE HCL 75MG CAP
VA PRODUCT IDENTIFIER N0088
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4001215
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE