LANSOPRAZOLE
lansoprazole 30 mg orally disintegrating tablet, 28
LANSOPRAZOLE (14342W)
14342W
Manner of administration:Oral
Restriction 15658
Indication: Scleroderma oesophagus
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
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| Max qty packs: 2 | Max qty units: 56 | # of repeats: 5 | DPMQ: $22.40 | Max safety net: $23.88 | General Patient Charge: $25.00 |
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DPMQ: $31.76 | Max safety net: $23.88 | General Patient Charge: $34.36 | ||
