| 02492490 | AG-Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02483289 | Accel-Rizatriptan ODT(Off-Formulary Interchangeable) | 7.7800 | 7.7800 |
| 02393492 | Apo-Rizatriptan RPD(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02458772 | CCP-Rizatriptan(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02374749 | Co Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02465094 | Jamp-Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02462796 | Mar-Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02240519 | Maxalt RPD(Off-Formulary Interchangeable) | 22.5608 | 11.1650 |
| 02439581 | Mint-Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02379201 | Mylan-Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02489384 | NRA-Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02436612 | Nat-Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1650 | 11.1650 |
| 02393379 | PMS-Rizatriptan RDT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02442914 | Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02446138 | Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02351889 | Sandoz Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |
| 02396688 | Teva-Rizatriptan ODT(Off-Formulary Interchangeable) | 11.1150 | 11.1150 |