Interchangeable Grouping
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92:00 UNCLASSIFIED THERAPEUTIC AGENTS
92:36:00 DISEASE-MODIFYING ANTIRHEUMATIC AGENTS
LU Criteria Text
TOFACITINIB
10mg Tab
Interchangeables found: 4
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02530015
Auro-Tofacitinib
10.5859
10.5859
02551705
Sandoz Tofacitinib
10.5859
10.5859
02511312
Taro-Tofacitinib
10.5859
10.5859
02480786
Xeljanz
43.7833
10.5859
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