PROPRANOLOL

propranolol hydrochloride 40 mg tablet, 100

PROPRANOLOL (13542R)

propranolol hydrochloride 40 mg tablet, 100
13542R
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 200 # of repeats: 5 DPMQ: $21.46 Max safety net: $23.00 General Patient Charge: $25.00
Available brands
APO-Propranolol
PROPRANOLOL-WGR
Deralin 40
*Additional charge for this brand is $5.60
 DPMQ: $27.06 Max safety net: $23.00 General Patient Charge: $30.60
Inderal
*Additional charge for this brand is $16.26
 DPMQ: $37.72 Max safety net: $23.00 General Patient Charge: $41.26