TRAMADOL

tramadol hydrochloride 50 mg capsule, 20

TRAMADOL (12008B)

tramadol hydrochloride 50 mg capsule, 20
12008B
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Severe pain
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 0.5 Max qty units: 10 # of repeats: 0 DPMQ: $17.09 Max safety net: $18.57 General Patient Charge: $21.36
Available brands
APO-Tramadol
TRAMADOL-WGR
Tramadol Sandoz
Tramedo
Zydol
Tramal
*Additional charge for this brand is $1.40
 DPMQ: $18.49 Max safety net: $18.57 General Patient Charge: $22.76