NORTRIPTYLINE HCL 10MG CAP (605)    VA PRODUCT (50.68)

Name Value
NAME NORTRIPTYLINE HCL 10MG CAP
VA GENERIC NAME NORTRIPTYLINE
DOSAGE FORM CAP,ORAL
FDA MED GUIDE Nortriptyline_(Generic)_(2017).pdf
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 10
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
DSS NUMBER 3
NATIONAL FORMULARY NAME NORTRIPTYLINE CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE YES
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
PGX ELIGIBLE YES
PGX SUPPRESSED YES
VA PRINT NAME NORTRIPTYLINE HCL 10MG CAP
VA PRODUCT IDENTIFIER N0084
TRANSMIT TO CMOP YES
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4001216
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE