Product Details
Jamp Doxepin
Doxepin HCl25 mg
Capsule
DIN/PIN/NPN
02559269
Manufacturer
Jamp Pharma Corporation
Formulary Listing Date
2026-07-31
Unit Price
0.1250
Amount MOH Pays
0.1250
Coverage Status
General Benefit
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
N06AA12
Interchangeable Products
| DIN/ PIN/ NPN | Brand name | Unit Price | Amount MOH pays |
|---|---|---|---|
| 00024333 | Sinequan | 0.5000 | 0.1250 |
| 02559099 | Mar-Doxepin | 0.2500 | 0.1250 |
| 02050005 | Apo-Doxepin | 0.1250 | 0.1250 |
| 02559269 | Jamp Doxepin | 0.1250 | 0.1250 |
LU Clinical Criteria
NORequirements