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Products found: 4

DIN/ PIN/ NPN	Generic Name	Brand Name, Strength & Dosage Form	MFR	Drug Benefit Price or Unit Price	Amount MOH Pays	Inter- change- able	Limited Use	Thera- peutic Notes
02212188	SUMATRIPTAN SUCCINATE	Imitrex (Off-Formulary Interchangeable) 6mg/0.5mL Inj Sol-Pref Syr 0.5mL Pk	GLW	47.5800	36.5888	YES	NO	NO
02163764	SUMATRIPTAN SUCCINATE	Imitrex (Off-Formulary Interchangeable) 50mg Tab	GSK	N/A	N/A	YES	NO	NO
01950614	SUMATRIPTAN SUCCINATE	Imitrex (Off-Formulary Interchangeable) 100mg Tab	GSK	N/A	N/A	YES	NO	NO
09857299	SUMATRIPTAN SUCCINATE	Imitrex (Off-Formulary Interchangeable) 25mg Tab	GSK	N/A	N/A	YES	NO	NO