GABAPENTIN
gabapentin 400 mg capsule, 100
GABAPENTIN (1835N)
1835N
Body System:
Manner of administration:Oral
Restriction 17445
Indication: Focal onset seizures
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
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| Max qty packs: 1 | Max qty units: 100 | # of repeats: 5 | DPMQ: $26.94 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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DPMQ: $29.14 | Max safety net: $25.00 | General Patient Charge: $27.20 | ||
