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Products found: 2
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DIN/ PIN/ NPN
Generic Name
Brand Name, Strength & Dosage Form
MFR
Drug Benefit Price or Unit Price
Amount MOH Pays
Interchangeable
Limited Use
Therapeutic Notes
02240521
RIZATRIPTAN
Maxalt (Off-Formulary Interchangeable) 10mg Tab
OCI
23.6888
11.1150
YES
NO
NO
02240520
RIZATRIPTAN
Maxalt (Off-Formulary Interchangeable) 5mg Tab
FRS
N/A
N/A
YES
NO
NO
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