Source	Section 100 (CT)
Body System	ALIMENTARY TRACT AND METABOLISM > ANTIEMETICS AND ANTINAUSEANTS > ANTIEMETICS AND ANTINAUSEANTS

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
5969EMP	ONDANSETRON ondansetron 4 mg wafer, 4 (PI, CMI)
	Available brands
	Zofran Zydisa * Additional charge for this brand is $2.28B	1	4	0	$5.78	$4.81	$7.09