Interchangeable Grouping
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12:00 AUTONOMIC AGENTS
12:08:08 PARASYMPATHOLYTIC (CHOLINERGIC BLOCKING) AGENTS ANTIMUSCARINICS/ANTISPASMODICS
LU Criteria Text
GLYCOPYRROLATE
4mg/20mL Inj Sol (With Preservative)
Interchangeables found: 2
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02473887
Glycopyrrolate Injection USP
2.7825
2.7825
09858164
Robinul
(Not a Benefit)
N/A
N/A
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