Interchangeable Grouping
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28:00 CENTRAL NERVOUS SYSTEM DRUGS
28:92:00 MISCELLANEOUS CENTRAL NERVOUS SYSTEM DRUGS
SUMATRIPTAN SUCCINATE
25mg Tab
Interchangeables found: 4
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02257882
Co Sumatriptan
(Off-Formulary Interchangeable)
8.9900
8.9900
09857299
Imitrex
(Off-Formulary Interchangeable)
N/A
N/A
02268906
Mylan-Sumatriptan
(Off-Formulary Interchangeable)
8.9900
8.9900
02256428
PMS-Sumatriptan
(Off-Formulary Interchangeable)
8.9900
8.9900
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