Interchangeable Grouping
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28:00 CENTRAL NERVOUS SYSTEM DRUGS
28:92:00 MISCELLANEOUS CENTRAL NERVOUS SYSTEM DRUGS
SUMATRIPTAN SUCCINATE
50mg Tab
Interchangeables found: 3
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02212153
Imitrex DF
(Off-Formulary Interchangeable)
17.8067
9.0650
02385570
Sumatriptan DF
(Off-Formulary Interchangeable)
9.0650
9.0650
02286823
Teva-Sumatriptan DF
(Off-Formulary Interchangeable)
9.0650
9.0650
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