RIVAROXABAN
rivaroxaban 2.5 mg tablet, 60
RIVAROXABAN (13366L)
13366L
Body System:
Manner of administration:Oral
Restriction 14298
Indication: Chronic stable atherosclerotic disease
Treatment phase: Continuing treatment
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 120 | # of repeats: 5 | DPMQ: $57.04 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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