Interchangeable Grouping
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92:00 UNCLASSIFIED THERAPEUTIC AGENTS
ICATIBANT
30mg/3mL Inj Sol-Pref Syr 3mL Pk
Interchangeables found: 2
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02425696
Firazyr
(Off-Formulary Interchangeable)
2700.0000
2025.0000
02547562
Icatibant Injection
(Off-Formulary Interchangeable)
2025.0000
2025.0000
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