Interchangeable Grouping
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28:00 CENTRAL NERVOUS SYSTEM DRUGS
28:12:00 ANTICONVULSANTS
LU Criteria Text
LEVETIRACETAM
250mg Tab
Interchangeables found: 17
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02399776
Ach-Levetiracetam
0.3210
0.3210
02274183
Act Levetiracetam
0.3210
0.3210
02285924
Apo-Levetiracetam
0.3210
0.3210
02375249
Auro-Levetiracetam
0.3210
0.3210
02504553
Jamp Levetiracetam Tablets
0.3210
0.3210
02403005
Jamp-Levetiracetam
0.3210
0.3210
02247027
Keppra
1.7836
0.3210
02442531
Levetiracetam
0.3210
0.3210
02454653
Levetiracetam
0.3210
0.3210
02353342
Levetiracetam
0.3210
0.3210
02524562
M-Levetiracetam
0.3210
0.3210
02442388
Mint-Levetiracetam
0.3210
0.3210
02499193
NRA-Levetiracetam
0.3210
0.3210
02440202
Nat-Levetiracetam
0.3210
0.3210
02296101
PMS-Levetiracetam
0.3210
0.3210
02482274
Riva-Levetiracetam
0.3210
0.3210
02461986
Sandoz Levetiracetam
0.3210
0.3210
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