SUMATRIPTAN
sumatriptan 50 mg tablet, 2
SUMATRIPTAN (8144P)
8144P
Body System:
Manner of administration:Oral
Restriction
Indication: Migraine attack
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 4 | # of repeats: 5 | DPMQ: $20.04 | Max safety net: $21.52 | General Patient Charge: $24.31 |
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